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Sun W, Li M, Lin Q, Jin X, Zhao B, Jiang Z, Zhang R, Li X. Arctiin Inhibits Hyperglycemia-Induced Oxidative Stress by Activating the Nrf2/HO-1 Signaling Pathway to Treat Type 2 Diabetic Osteoporosis. Mol Nutr Food Res 2025; 69:e70053. [PMID: 40177855 DOI: 10.1002/mnfr.70053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2024] [Revised: 01/15/2025] [Accepted: 03/11/2025] [Indexed: 04/05/2025]
Abstract
Arctiin (ARC), a primary component of burdock (Arctium lappa L.), is widely recognized as a traditional herb and nutritional supplement in Asia. This study set out to explore its potential impact on type 2 diabetic osteoporosis (T2DOP). MC3T3-E1 cells were exposed to a high-glucose environment to simulate diabetic conditions. Treatment with ARC increased the expression of crucial osteogenic transcription factor genes, such as RUNX2, Osterix, and COL1A1. Moreover, ARC mitigated the production of ROS induced by high glucose levels. For in vivo experimentation, db/db mice were used as models for T2DOP. ARC supplementation decreased bone loss and improved bone structural integrity. Collectively, our findings indicate that ARC holds promise as a nutritional intervention for the treatment of T2DOP. By activating the Nrf2/HO-1 signaling pathway, ARC could help counteract oxidative stress and impaired bone differentiation associated with diabetes, thus offering a potential dietary strategy to support bone health. Incorporating ARC-containing foods or supplements into the diet could be a beneficial approach to enhance overall bone quality and potentially reduce the risk of fractures and other bone-related problems in patients with diabetes, highlighting the importance of considering natural compounds for the nutritional management of chronic diseases.
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Affiliation(s)
- Weipeng Sun
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Minying Li
- School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Qing Lin
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Xueshan Jin
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Biyi Zhao
- College of Traditional Chinese Medicine, Jinan University, Guangzhou, Guangdong Province, China
| | - Ziwei Jiang
- Department of Orthopaedics, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Ronghua Zhang
- College of Pharmacy, Jinan University, Guangzhou, Guangdong Province, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, Guangdong Province, China
- College of Cancer Institute, Jinan University, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Xiaoyun Li
- College of Pharmacy, Jinan University, Guangzhou, Guangdong Province, China
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He Y, Liu T, Peng X, Yao C, Zhou D, Song C, Wei Z, Chen J, Liu Z, Jiang F. Molecular mechanism of mitochondrial autophagy mediating impaired energy metabolism leading to osteoporosis. Biochim Biophys Acta Mol Basis Dis 2025; 1871:167685. [PMID: 39842521 DOI: 10.1016/j.bbadis.2025.167685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2024] [Revised: 01/09/2025] [Accepted: 01/17/2025] [Indexed: 01/24/2025]
Abstract
Osteoporosis (OP) is a bone metabolic disease caused by decreased bone mass leading to destruction of bone microstructure. Treatment of OP is characterized by a lifelong nature, causing extreme financial and psychological burdens to patients. Hormonal abnormalities, cellular autophagy, Ferroptosis, and oxidative stress are all part of the intricate and varied pathophysiology of OP. Recent research has revealed that mitochondrial dysfunction is a significant factor in the onset and progression of OP. By regulating bone marrow mesenchymal stem cell differentiation through various signaling pathways and cytokines, abnormal mitochondrial energy metabolism brought on by oxidative stress processes impacts osteoblast and osteoclast proliferation and differentiation, causing an imbalance in bone metabolism that ultimately results in OP. Therefore, one possible method to prevent and manage OP may be to use mitochondria as a carrier to trigger osteogenic differentiation of bone marrow mesenchymal stem cells from mitochondrial energy consumption, oxidative stress, autophagy, and osteoclast death. In order to offer some theoretical references and therapeutic approaches for the clinical prevention and treatment of OP, we will examine the pathophysiology of OP from mitochondrial dysfunction in this work.
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Affiliation(s)
- Yuheng He
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China; College of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Tao Liu
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Xin Peng
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China; College of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Chaorui Yao
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China; College of Integrated Chinese and Western Medicine, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Daqian Zhou
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Chao Song
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China; Department of Orthopedics, RuiKang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
| | - Zhangchao Wei
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Jinwen Chen
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China.
| | - Zongchao Liu
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China; Luzhou Longmatan District People's Hospital, Luzhou 646000, Sichuan Province, China.
| | - Feng Jiang
- Department of Orthopedics and Traumatology, The Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, Sichuan Province, China.
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Dong R, Wei J, Tian S, Wang J, Ma Y, Li Y, Liu RX, Liu YQ. Single-cell RNA transcriptomics reveals Du-Zhong-Wan promotes osteoporotic fracture healing via YAP/β-catenin/VEGF axis in BMSCs. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 135:155572. [PMID: 39366157 DOI: 10.1016/j.phymed.2024.155572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 01/29/2024] [Accepted: 03/27/2024] [Indexed: 10/06/2024]
Abstract
BACKGROUND Our previous study demonstrated that Du-Zhong-Wan (DZW) promoted osteoporotic fracture (OPF) healing by enhancing osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and angiogenesis of endothelial cells (ECs). However, the heterogeneity of BMSCs and ECs, as well as the specific molecular mechanism underlying these effects, still require further evaluation. PURPOSE The primary objective of this study was to elucidate the heterogeneity of BMSCs and ECs, as well as the cellular-level mechanism of DZW against OPF through single-cell RNA sequencing. METHODS In this study, we presented a single-cell atlas of mouse femoral callus, comparing samples with and without DZW treatment, utilizing single-cell RNA sequencing. Variable genes were identified using the FindVariableGenes (FVG) and principal component analysis (PCA) analysis. Additionally, uniform manifold approximation and projection (U-MAP) was employed to reduce and visualize the distinct subclusters. The CellPhoneDB2 method was employed to analyze intercellular communication and quantify the interaction between ligands and receptors within distinct cell clusters. The osteogenic differentiation capacity of BMSCs was assessed by micro-CT, alkaline phosphatase (ALP), and alizarin red S (ARS) assay. The scratch wound assay and tube formation assay were utilized to assess the angiogenic capabilities of ECs in vitro. Additionally, western blot and immunofluorescence experiments were utilized to elucidate the related protein expression. RESULTS Consistent with our previous studies, DZW obviously promoted osteoporotic fracture healing. Moreover, this study discovered 14 cell clusters at the femoral fracture callus, where the BMSCs most actively interacted with ECs, through single-cell sequencing. Notably, DZW significantly elevated the proportion of Lepr+ BMSCs and Podxl+ ECs subgroup, which were respectively considered essential cells for osteoblastogenesis and angiogenesis of arteriolar vessels. The increased proportion of Podxl+ ECs was partially attributed to vascular endothelial growth factor (VEGF), secreted by BMSCs, which were able to be reversed by YAP pharmacological inhibitor verteporfin. Furthermore, the western blot assay revealed elevated expression levels of YAP/β-catenin, VEGF, RUNX2, and OCN in BMSCs treated with DZW, which were counteracted by verteporfin. CONCLUSION The data above indicates that DZW elevates the proportion of LEPR+ BMSCs and Podxl+ ECs, therefore contributing for the osteogenic ability of BMSCs and BMSCs-mediated angiogenesis via activation of the YAP/β-catenin/VEGF axis, which provides novel potential targets and mechanism for DZW in treating OPF in sub-clusters and molecular level.
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Affiliation(s)
- Renchao Dong
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jun Wei
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Shuo Tian
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Jie Wang
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yu Ma
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Yilin Li
- Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Rui-Xia Liu
- The First Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Yan-Qiu Liu
- Shandong University of Traditional Chinese Medicine, Jinan, China.
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4
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Wang W, Yang H, Fan Z, Shi R. NQO1 promotes osteogenesis and suppresses angiogenesis in DPSCs via MAPK pathway modulation. Stem Cell Res Ther 2024; 15:306. [PMID: 39285500 PMCID: PMC11406740 DOI: 10.1186/s13287-024-03929-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Accepted: 09/06/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Influence on stem cells' angiogenesis and osteogenesis of NAD(P)H Quinone Dehydrogenase 1(NQO1) has been established, but its impact on dental pulp stem cells (DPSCs) is unexplored. An important strategy for the treatment of arteriosclerosis is to inhibit calcium deposition and to promote vascular repair and angiogenesis. This study investigated the function and mechanism of NQO1 on angiogenesis and osteogenesis of DPSCs, so as to provide a new ideal for the treatment of arteriosclerosis. METHODS Co-culture of human DPSCs and human umbilical vein endothelial cells (HUVECs) was used to detect the angiogenesis ability. Alkaline phosphatase (ALP) activity, alizarin red staining (ARS), and transplantation of HA/tricalcium phosphate with DPSCs were used to detect osteogenesis. RESULTS NQO1 suppressed in vitro tubule formation, migration, chemotaxis, and in vivo angiogenesis, as evidenced by reduced CD31 expression. It also enhanced ALP activity, ARS, DSPP expression and osteogenesis and boosted mitochondrial function in DPSCs. CoQ10, an electron transport chain activator, counteracted the effects of NQO1 knockdown on these processes. Additionally, NQO1 downregulated MAPK signaling, which was reversed by CoQ10 supplementation in DPSCs-NQO1sh. CONCLUSIONS NQO1 inhibited angiogenesis and promoted the osteogenesis of DPSCs by suppressing MAPK signaling pathways and enhancing mitochondrial respiration.
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Affiliation(s)
- Wanqing Wang
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Haoqing Yang
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China
| | - Zhipeng Fan
- Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China.
- Beijing Laboratory of Oral Health, Capital Medical University, Beijing, 100069, China.
- Research Unit of Tooth Development and Regeneration, Chinese Academy of Medical Sciences, Beijing, China.
| | - Ruitang Shi
- Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, 100050, China.
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5
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Huang J, Jiang H, Wang H, Xue Q, Hu M, Li Y. Aucubin produces anti-osteoporotic effects under mechanical stretch stress and orthodontic tooth movement. Chem Biol Interact 2024; 393:110955. [PMID: 38492842 DOI: 10.1016/j.cbi.2024.110955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 03/05/2024] [Accepted: 03/10/2024] [Indexed: 03/18/2024]
Abstract
Aucubin (AU), an iridoid glycoside extracted from Eucommia ulmoides, exerts anti-osteoporotic effects by promoting osteogenesis, as reported in previous studies. Here, we investigated the effects of AU under mechanical stretch stress. MC3T3-E1 cells were treated with dexamethasone (DEX) in vitro and subjected to mechanical stretch stress to establish an osteoporotic orthodontic force cell model. AU treatment increased the mRNA and protein expressions of BMP2, OPN, RUNX2, COL-1 and other osteogenic differentiation factors in MC3T3-E1 cells. Furthermore, we established an in vivo orthodontic tooth movement (OTM) model of osteoporosis. Serum parameter detection of ALP concentration, radiography of the femur, hematoxylin-eosin (HE) staining, and micro-CT of the maxilla confirmed that AU could partially reverse the damage induced by DEX. Immunohistochemical (IHC) analysis showed that AU increased the expression of COL-1, OCN, and OPN on the tension side of the periodontium. In conclusion, AU treatment promotes osteogenic differentiation under mechanical stretch stress and positively affects bone remodeling during OTM in DEX-induced osteoporosis.
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Affiliation(s)
- Jiamiao Huang
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, China
| | - Huan Jiang
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, China
| | - Haoyu Wang
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, China
| | - Qing Xue
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, China
| | - Min Hu
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, China
| | - Yutong Li
- Department of Orthodontics, School and Hospital of Stomatology, Jilin University, Changchun, 130021, China; Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun, 130021, China; School of Life Sciences, Jilin University, Changchun, 130012, China.
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6
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Lu K, Wang D, Zou G, Wu Y, Li F, Song Q, Sun Y. A multifunctional composite hydrogel that sequentially modulates the process of bone healing and guides the repair of bone defects. Biomed Mater 2024; 19:035010. [PMID: 38422521 DOI: 10.1088/1748-605x/ad2ed1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 02/29/2024] [Indexed: 03/02/2024]
Abstract
Calcium carbonate (CaCO3), which exhibits excellent biocompatibility and bioactivity, is a well-established bone filling material for bone defects. Here, we synthesized CaCO3microspheres (CMs) to use as an intelligent carrier to load bone morphogenetic protein-2 (BMP-2). Subsequently, drug-loaded CMs and catalase (CAT) were added to methacrylated gelatin (GelMA) hydrogels to prepare a composite hydrogel for differential release of the drugs. CAT inside hydrogels was released with a fast rate to eliminate H2O2and generate oxygen. Constant BMP-2 release from CMs induced rapid osteogenesis. Resultsin vitroindicated that the composite hydrogels efficiently reduced the level of intracellular reactive oxygen species, preventing cells from being injured by oxidative stress, promoting cell survival and proliferation, and enhancing osteogenesis. Furthermore, animal experiments demonstrated that the composite hydrogels were able to inhibit the inflammatory response, regulate macrophage polarization, and facilitate the healing of bone defects. These findings indicate that a multi-pronged strategy is greatly expected to promote the bone healing by modulating pathological microenvironments.
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Affiliation(s)
- Kun Lu
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
- Department of Orthopedics, Yancheng First People's Hospital of Jiangsu Province, Yancheng, Jiangsu, People's Republic of China
| | - Dongliang Wang
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
- Department of Orthopedics, Yancheng First People's Hospital of Jiangsu Province, Yancheng, Jiangsu, People's Republic of China
| | - Guoyou Zou
- Department of Orthopedics, Yancheng First People's Hospital of Jiangsu Province, Yancheng, Jiangsu, People's Republic of China
| | - Ya Wu
- Department of Orthopedics, Yancheng First People's Hospital of Jiangsu Province, Yancheng, Jiangsu, People's Republic of China
| | - Feng Li
- Department of Orthopedics, Yancheng First People's Hospital of Jiangsu Province, Yancheng, Jiangsu, People's Republic of China
| | - Qunshan Song
- Department of Orthopedics, Yancheng First People's Hospital of Jiangsu Province, Yancheng, Jiangsu, People's Republic of China
| | - Yongming Sun
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
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7
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Yang F, Lian Q, Zhang X, Sun F, Jia S, Zhao W. Aucubin provides protection against cerebral ischaemia-reperfusion injury by suppressing neuronal apoptosis, oxidative stress, and inflammation through the modulation of the AKT-GSK-3β-Nrf2 signal cascade. Toxicol Appl Pharmacol 2024; 483:116829. [PMID: 38246288 DOI: 10.1016/j.taap.2024.116829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 01/02/2024] [Accepted: 01/18/2024] [Indexed: 01/23/2024]
Abstract
Aucubin (AU) is a naturally occurring iridoid glycoside known to possess a wide range of pharmacological properties and exhibit a notable protective effect against various pathological conditions. Studies have shown that AU has neuroprotective properties in different neurological diseases. However, its potential protective effects against cerebral ischemia-reperfusion (CIR) injury have not been thoroughly investigated. This study aimed to investigate the impact of AU on CIR injury and explore the underlying mechanism. Cultured neurons treated with AU showed a significant reduction in apoptosis, oxidative stress, and inflammation caused by oxygen-glucose deprivation and reoxygenation (OGD/R). In a rat model of CIR, treatment with AU resulted in a significant decrease in cerebral infarct size and neurological deficits. AU treatment also reversed the increased apoptosis, oxidative stress, and inflammation in the brains of CIR rats. Furthermore, AU was found to enhance the activation of nuclear factor-erythroid 2-related factor 2 (Nrf2), accompanied by increased phosphorylation of serine/threonine-protein kinase AKT and glycogen synthase kinase-3 beta (GSK-3β). The activation of Nrf2 induced by AU was reversed when the AKT-GSK-3β cascade was blocked. Additionally, the neuroprotective effect of AU was significantly reduced when Nrf2 was pharmacologically suppressed. In conclusion, these findings suggest that AU exerts a neuroprotective effect on CIR injury, and this effect is mediated by the activation of Nrf2 through the AKT-GSK-3β axis. This work highlights the potential of AU as a drug candidate for the treatment of CIR injury.
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Affiliation(s)
- Fang Yang
- Department of Pharmacy, Xianyang Hospital of Yan'an University, Xianyang 712000, Shaanxi Province, China.
| | - Qiufang Lian
- Department of Cardiology, Xianyang Hospital of Yan'an University, Xianyang 712000, Shaanxi Province, China.
| | - Xin Zhang
- College of Pharmacy, Shaanxi University of Chinese Medicine, Xianyang 712046, Shaanxi Province, China
| | - Feng Sun
- Department of Scientific Research, Xianyang Hospital of Yan'an University, Xianyang 712000, Shaanxi Province, China
| | - Shuaiyun Jia
- Department of Pharmacy, Xianyang Hospital of Yan'an University, Xianyang 712000, Shaanxi Province, China
| | - Wei Zhao
- Department of Cardiology, Xianyang Hospital of Yan'an University, Xianyang 712000, Shaanxi Province, China
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8
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Liao Y, Chen F, Tang H, Dessie W, Qin Z. Extraction and Purification of Aucubin from Eucommia ulmoides Seed Draff in Natural Deep Eutectic Solvents Using Macroporous Resins. ACS OMEGA 2024; 9:1723-1737. [PMID: 38222590 PMCID: PMC10785622 DOI: 10.1021/acsomega.3c08332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/16/2024]
Abstract
Aucubin (AU) is an active ingredient that exerts strong antioxidant and anti-inflammatory effects in the treatment of several diseases. In order to improve the efficiency of resource utilization of traditional biomass waste, Eucommia ulmoides seed-draff (EUSD) waste biomass was used as the raw material, and a series of deep eutectic solvents were selected to evaluate the extraction efficiency of aucubin from EUSD. A response surface experiment was designed based on a single-factor experiment to optimize the extract conditions. The results showed that the best conditions for aucubin extraction were an HBD-HBA ratio of 2.18, a liquid-solid ratio of 46.92 mL/g, a water percentage of 37.95%, a temperature of 321.03 K, and an extraction time of 59.55 min. The maximum amount of aucubin was 156.4 mg/g, which was consistent with the theoretical value (156.8 mg/g). Then, the performance of 12 resins for adsorption and desorption was contrasted. The results revealed that HPD950 resin exhibited the best performance, with an adsorption capacity of 95.2% and a desorption capacity of 94.3%. Additionally, the pseudo-second-order model provided the best match to the kinetics data, the Langmuir model provided the best fit to the isotherm data, and adsorption was a beneficial, spontaneous, exothermic, and physical process. In the recyclability test, the HPD950 resin had great potential and excellent sustainability in aucubin recovery. In the antioxidant activity study, the aucubin extract exerted a strong antioxidant ability with scavenging capabilities for four free radicals. Furthermore, the antifungal activity study found that the aucubin extract exhibited a good antifungal effect against 5 tested pathogens. The research results can provide a theoretical basis for the extraction of high-value components from waste biomass by deep eutectic solvent and a certain application value for the development and utilization of natural aucubin products.
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Affiliation(s)
- Yunhui Liao
- College
of Chemistry and Bioengineering, Hunan University
of Science and Engineering, Yongzhou 425199, China
- Hunan
Engineering Technology Research Center for Comprehensive Development
and Utilization of Biomass Resources, Yongzhou 425199, China
| | - Feng Chen
- College
of Chemistry and Bioengineering, Hunan University
of Science and Engineering, Yongzhou 425199, China
| | - Haishan Tang
- College
of Chemistry and Bioengineering, Hunan University
of Science and Engineering, Yongzhou 425199, China
- Hunan
Provincial Key Laboratory for Comprehensive Utilization of Dominant
Plant Resources in Southern Hunan, Yongzhou 425199, China
| | - Wubliker Dessie
- College
of Chemistry and Bioengineering, Hunan University
of Science and Engineering, Yongzhou 425199, China
- Hunan
Engineering Technology Research Center for Comprehensive Development
and Utilization of Biomass Resources, Yongzhou 425199, China
| | - Zuodong Qin
- College
of Chemistry and Bioengineering, Hunan University
of Science and Engineering, Yongzhou 425199, China
- Hunan
Engineering Technology Research Center for Comprehensive Development
and Utilization of Biomass Resources, Yongzhou 425199, China
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9
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Che J, Yang X, Jin Z, Xu C. Nrf2: A promising therapeutic target in bone-related diseases. Biomed Pharmacother 2023; 168:115748. [PMID: 37865995 DOI: 10.1016/j.biopha.2023.115748] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 10/24/2023] Open
Abstract
Nuclear factor erythroid-2-related factor 2 (Nrf2) plays an important role in maintaining cellular homeostasis, as it suppresses cell damage caused by external stimuli by regulating the transcription of intracellular defense-related genes. Accumulating evidence has highlighted the crucial role of reduction-oxidation (REDOX) imbalance in the development of bone-related diseases. Nrf2, a transcription factor linked to nuclear factor-erythrocyte 2, plays a pivotal role in the regulation of oxidative stress and induction of antioxidant defenses. Therefore, further investigation of the mechanism and function of Nrf2 in bone-related diseases is essential. Considerable evidence suggests that increased nuclear transcription of Nrf2 in response to external stimuli promotes the expression of intracellular antioxidant-related genes, which in turn leads to the inhibition of bone remodeling imbalance, improved fracture recovery, reduced occurrence of osteoarthritis, and greater tumor resistance. Certain natural extracts can selectively target Nrf2, potentially offering therapeutic benefits for osteogenic arthropathy. In this article, the biological characteristics of Nrf2 are reviewed, the intricate interplay between Nrf2-regulated REDOX imbalance and bone-related diseases is explored, and the potential preventive and protective effects of natural products targeting Nrf2 in these diseases are elucidated. A comprehensive understanding of the role of Nrf2 in the development of bone-related diseases provides valuable insights into clinical interventions and can facilitate the discovery of novel Nrf2-targeting drugs.
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Affiliation(s)
- Jingmin Che
- Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China; Shaanxi Engineering Research Center of Cell Immunology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
| | - Xiaoli Yang
- Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China; Shaanxi Engineering Research Center of Cell Immunology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Zhankui Jin
- Department of Orthopedics, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China.
| | - Cuixiang Xu
- Shaanxi Provincial Key Laboratory of Infection and Immune Diseases, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China; Shaanxi Engineering Research Center of Cell Immunology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
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10
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Qian F, Huang Z, Liu W, Liu Y, He X. Functional β-TCP/MnO 2 /PCL artificial periosteum promoting osteogenic differentiation of BMSCs by reducing locally reactive oxygen species level. J Biomed Mater Res A 2023; 111:1678-1691. [PMID: 37265324 DOI: 10.1002/jbm.a.37576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 05/18/2023] [Accepted: 05/24/2023] [Indexed: 06/03/2023]
Abstract
Segmental bone defects caused by trauma, tumor resection or congenital malformations are often reconstructed with autologous, allogeneic bone grafts or artificial bone materials, of which, about 5% ~ 10% will have delayed healing or even nonunion of fractures. The loss of periosteum and excessive accumulation of ROS in fracture site leads to the aging of osteoblasts and the decline of their proliferation and differentiation, thus affecting the fracture healing process. In this study, we prepared a functional modified artificial periosteum β-TCP/MnO2 /PCL(β-TMP) by electrospinning with a function of catalyzing decomposition of H2 O2 . We examined the surface morphology of β-TMP, the concentration of Ca, P and Mn of β-TMP, as well as the diameter distribution range of nanofibers on β-TMP. Through X-ray diffraction patterns and Fourier transform infrared spectra, β-TMP was characterized and its hydrophilicity was tested. The release of Mn2+ and Ca2+ of 0.1 and 0.05% β-TMP in different pH values (7.4 and 5.5) determined by ICP. We also identified that β-TMP could reduce the level of ROS in cells by lowering the level of H2 O2 . 0%, 0.05% and 0.1% β-TMP displayed good cell compatibility, cell adhesion and cellular morphology in the condition with or without H2 O2 . 0.5% β-TMP showed compromised cell compatibility in normal condition, however, the compromised phenotypes could be partially rescued in the present of H2 O2 . Compared with 0%, 0.05% and 0.1% β-TMP displayed higher osteoblastic differentiation with or without H2 O2 in BMSCs as well as in MG-63. In sum, β-TMP helped osteogenesis and promoted repair of bone defects.
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Affiliation(s)
- Feng Qian
- Department of Inorganic Materials, School of Minerals Processing and Bioengineering, Central South University, Changsha, China
- Hunan Key Lab of Mineral Materials and Application, Central South University, Changsha, China
| | - Zongwang Huang
- Department of Inorganic Materials, School of Minerals Processing and Bioengineering, Central South University, Changsha, China
- Hunan Key Lab of Mineral Materials and Application, Central South University, Changsha, China
| | - Wenbin Liu
- Department of Orthopedics, The third Xiangya hospital, Central South University, Changsha, China
| | - Yanling Liu
- Department of Urology, Provincial Laboratory for Diagnosis and Treatment of Genitourinary System Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Xi He
- Department of Sports Medicine, Xiangya Hospital, Central South University, Changsha, China
- Department of Orthopedics, The First Affiliated Hospital, Zhejiang University school of medicine, Hangzhou, China
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Shi X, Jiang W, Yang X, Ma H, Wang Z, Ai Q, Dong Y, Zhang Y, Shi Y. Aucubin inhibits hepatic stellate cell activation through stimulating Nrf2/Smad7 axis. Eur J Pharmacol 2023; 957:176002. [PMID: 37607604 DOI: 10.1016/j.ejphar.2023.176002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/24/2023]
Abstract
AIM Liver fibrosis may develop into end-stage liver disease if left unprevented. The study is attempting to identify a compound to ameliorate liver fibrosis progression with high efficiency and low toxicity, as well as to analyze its potential molecular mechanism. METHODS The drug screening was performed using human hepatic stellate cell line LX-2 for identifying the compound as collagen I inhibitor. Primary Human hepatic stellate cells and LX-2 cell line were used to detect the antifibrotic function activity and molecular mechanism analysis in vitro. The CCl4-induced mouse experimental model was used to measure the amelioration in liver fibrosis. RESULTS This study identified Aucubin, a natural compound, as a candidate for anti-liver fibrosis. Besides, Aucubin could inhibit the collagen I and α-SMA expressions in LX-2 cells and primary human hepatic stellate cells, as well as the cell proliferation. In terms of mechanism, Aucubin could upregulate Smad7 in hepatic stellate cells in a dose-dependent manner and block TGF-β signaling. We also found that Nrf2 might be a direct target for the action of Aucubin, whose activation was necessary for Smad7 upregulation. In an in-vivo mouse model, Aucubin efficiency ameliorated the progression of CCl4-induced liver fibrosis, and reduced the hepatic levels of collagen deposition, transaminase and inflammatory cytokines. CONCLUSION Capable of inhibiting the activation of hepatic stellate cells in vitro and in vivo, Aucubin may be a potential therapeutic candidate for liver fibrosis, which is dependent on the suppression of TGF-β signaling through stimulating Nrf2/Smad7 axis.
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Affiliation(s)
- Xu Shi
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, Changchun, 130031, Jilin, China
| | - Wenyan Jiang
- Department of Radiology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - XiaoGuang Yang
- National Engineering Laboratory for Druggable Gene and Protein Screening, Northeast Normal University, Changchun, 130000, Jilin, China
| | - HeMing Ma
- Department of Gastroenterology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Zhongfeng Wang
- Department of Hepatology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Qing Ai
- Department of Laboratory Medicine, Lequn Branch, The First Hospital of Jilin University, Changchun, 130031, Jilin, China
| | - YuTong Dong
- Department of Hepatology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - YingYu Zhang
- Department of Hepatology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China
| | - Ying Shi
- Department of Hepatology, The First Hospital of Jilin University, Changchun, 130021, Jilin, China.
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Wang Z, Wu J, Li L, Wang K, Wu X, Chen H, Shi J, Zhou C, Zhang W, Hang K, Xue D, Pan Z. Eicosapentaenoic acid supplementation modulates the osteoblast/osteoclast balance in inflammatory environments and protects against estrogen deficiency-induced bone loss in mice. Clin Nutr 2023; 42:1715-1727. [PMID: 37542949 DOI: 10.1016/j.clnu.2023.07.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 07/13/2023] [Accepted: 07/23/2023] [Indexed: 08/07/2023]
Abstract
BACKGROUND An imbalance of osteoblasts (OBs) and osteoclasts (OCs) in a chronic inflammatory microenvironment is an important pathological factor leading to osteoporosis. Eicosapentaenoic acid (EPA) has been shown to suppress inflammation in macrophages and adipocytes. However, the effect of EPA on OBs and OCs has yet to be fully elucidated. AIMS We explored the roles of EPA in the differentiation of OBs and OCs, as well as the coupling between OBs and OCs in an inflammatory microenvironment. The effects of EPA on estrogen deficiency-induced osteoporosis were also evaluated. METHODS Mouse bone marrow mesenchymal stem cells (mBMSCs) and mouse bone marrow-derived macrophages (mBMMs) were used for in vitro OBs and OCs differentiation. TNF-α was used to create an inflammatory microenvironment. We examined the effects of EPA on osteoblastogenesis in the absence or presence of TNF-α and collect OBs' culture medium as the conditioned medium (CM). Then we examined the effects of EPA and CM on RANKL-induced osteoclastogenesis. The in vivo effects of EPA were determined using an ovariectomized (OVX) mouse model treated with EPA or vehicle. RESULTS High-dose EPA was shown to promote osteoblastogenesis in an inflammatory environment in vitro, as well as upregulate expression of OBs-specific proteins and genes. ARS and ALP staining also showed that high-dose EPA-treated groups restored mBMSCs' impaired osteogenic capacity caused by TNFa. Mechanistically, EPA suppressed the NF-κB pathway activated by TNF-α in mBMSCs and rescued TNF-α-mediated inhibition of osteoblastogenesis. EPA was also shown to inhibit expression of RANKL and decrease the RANKL/OPG ratio in OBs in an inflammatory environment. CM from TNF-α-stimulated OBs promoted osteoclastogenesis of mBMMs; EPA-treated CM prevented this. In the OVX mouse model, EPA supplementation prevented bone loss in an estrogen deficiency-induced inflammatory environment. CONCLUSIONS EPA was demonstrated for the first time to restore mBMSCs' impaired osteogenic capacity caused by TNFa-induced inflammation and rescue the OBs/OCs balance via regulation of RANKL and OPG expression in OBs. EPA showed a remarkable ability to prevent bone loss in OVX mice, suggesting a potential application of EPA in postmenopausal osteoporosis.
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Affiliation(s)
- Zhongxiang Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China; Clinical Research Center of Motor System Disease of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China
| | - Jiaqi Wu
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China
| | - Lijun Li
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China; Clinical Research Center of Motor System Disease of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China
| | - Kanbin Wang
- Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China; Clinical Research Center of Motor System Disease of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China; Department of Orthopedic Surgery, The Fourth Affiliated Hospital, International Institutes of Medicine, Zhejiang University School of Medicine, 322000 Yiwu, Zhejiang Province, PR China
| | - Xiaoyong Wu
- Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China; Clinical Research Center of Motor System Disease of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China
| | - Hongyu Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China
| | - Jiujun Shi
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China
| | - Chengwei Zhou
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China; Key Laboratory of Motor System Disease Research and Precision Therapy of Zhejiang Province, 310000 Hangzhou, Zhejiang Province, PR China
| | - Weijun Zhang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China
| | - Kai Hang
- Department of Orthopedic Surgery, The Children's Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China
| | - Deting Xue
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China.
| | - Zhijun Pan
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, 310000 Hangzhou, Zhejiang Province, PR China; Orthopedics Research Institute of Zhejiang University, 310000 Hangzhou, Zhejiang Province, PR China.
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Chen Y, Lu C, Shang X, Wu K, Chen K. Primary cilia: The central role in the electromagnetic field induced bone healing. Front Pharmacol 2022; 13:1062119. [DOI: 10.3389/fphar.2022.1062119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/07/2022] [Indexed: 12/03/2022] Open
Abstract
Primary cilia have emerged as the cellular “antenna” that can receive and transduce extracellular chemical/physical signals, thus playing an important role in regulating cellular activities. Although the electromagnetic field (EMF) is an effective treatment for bone fractures since 1978, however, the detailed mechanisms leading to such positive effects are still unclear. Primary cilia may play a central role in receiving EMF signals, translating physical signals into biochemical information, and initiating various signalingsignaling pathways to transduce signals into the nucleus. In this review, we elucidated the process of bone healing, the structure, and function of primary cilia, as well as the application and mechanism of EMF in treating fracture healing. To comprehensively understand the process of bone healing, we used bioinformatics to analyze the molecular change and associated the results with other studies. Moreover, this review summarizedsummarized some limitations in EMFs-related research and provides an outlook for ongoing studies. In conclusion, this review illustrated the primary cilia and related molecular mechanisms in the EMF-induced bone healing process, and it may shed light on future research.
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Yao XW, Liu HD, Ren MX, Li TL, Jiang WK, Zhou Z, Liu ZY, Yang M. Aloe polysaccharide promotes osteogenesis potential of adipose-derived stromal cells via BMP-2/Smads and prevents ovariectomized-induced osteoporosis. Mol Biol Rep 2022; 49:11913-11924. [PMID: 36243792 PMCID: PMC9712288 DOI: 10.1007/s11033-022-08003-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 10/03/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Aloe polysaccharide (AP) is a type of an active macromolecule of Aloe vera, which contributes to its function. However, whether AP possesses anti-osteoporosis properties is unknown. METHODS Adipose-derived stromal cells were treated with different concentrations of AP. Early and late osteogenesis were, respectively, evaluated by ALP and Alizarin Red S staining. The effect of AP on the processes of adipogenesis inhibition in ADSCs was analyzed by oil red O staining. Western blot was used to assess the expression of osteogenic and adipogenic related factors. Then, Noggin was administered to further confirm the mechanism by which AP promotes the osteogenesis of ADSCs. Finally, 40 female SD rats were classified into a bilateral laparotomy group (Sham group) and three bilateral ovariectomy groups: OVX group, OVX + AP group, and OVX + AP + Noggin group. The bilateral rat femurs were collected to perform micro-CT scanning, HE, Masson trichrome, and Oil red O staining. RESULTS The results indicated that AP could increase ALP expression and calcium deposition. Through molecular mechanisms, AP promotes the protein expression of COL1A1, OPN, and ALP in ADSCs, but downregulates the expression of PPARγ. Also, AP directs ADSCs' fate by stimulating the BMP2/Smads signaling pathway. In vivo, the rat AP-treated had more trabecular bone than the OVX rat, indicating partial protection from cancellous bone loss after treatment with AP. CONCLUSION Our results show that AP may promote osteogenesis of ADSCs through BMP-2/Smads signaling pathway and inhibits lipogenic differentiation. Thus, AP might be a promising alternative medicine to treat postmenopausal osteoporosis.
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Affiliation(s)
- Xue-wei Yao
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - He-dong Liu
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - Mao-xian Ren
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - Tian-lin Li
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - Wen-kai Jiang
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - Zhi Zhou
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - Zhi-yi Liu
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
| | - Min Yang
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No.2, Zheshan Xi Road, Wuhu, 241001 Anhui People’s Republic of China
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