| BackgroundOsteonecrosis of the Femoral Head(ONFH) is defined as blood supply impairment or interruption of the femoral head caused by various factors and lead to deformation and necrosis of osteocyte and bone marrow, and subsequent structure change of the femoral head. Patients suffer dysfunction and pain of the hip in its late collapse stage. ONFH is one of the most common seen, generally happens, and difficult disease, which can cause bad prognosis and high rates of disability. In recent years, steroid-induced avascular necrosis of the femoral head(SANFH) has become the top list of all kinds of ONFH because of steroid widely usage in clinical practice.It provides great help to the early diagnosis and treatment when figuring out the exact mechanism of SANFH. However, the mechanism is still not clear. Current theories include lipid metabolism disorder, intravascular coagulation, osteoporosis, high pressure in the bone, increased blood viscosity, vascular inflammatory change, and other undefined theories.Proteomic technology becomes new research area in the post-genetic stage and develops rapidly. Diversity and complexity of biological phenomena is the direct expression of genetic function activities. In order to reveal the laws of complete vital movement, we should put research into protein, which is the product of genetic expression.Chinese medicine has played an irreplaceable role in the early prevention and treatment of SANFH. Multiple documents reported that various of Chinese medicine monomers and compounds showed definite efficacy in the treatment of SANFH. Multiple basis experiments and clinical research has proved that Yuan Shi Sheng Mai Cheng Gu Tablet has the function of invigorating the kidney and strengthening the bone, promoting blood circulation and alleviating pain, improving immunity. It’s still unclear that the change of serum protein markers and exact working mechanism in patients who were administered Yuan Shi Sheng Mai Cheng Gu Tablet for early SANFH. Further studies are essentially needed for improving efficacy and new pharmaceutical development.Material and methods1. Basis research A total of20ONFH patients in ARCOI and Ⅱ stages were gathered in the out-patient orthopedic department of the first affiliated hospital of TCM from Mar,2012to Sep,2013. We collected included patients pre-intervention(the control group) serum and stored at subzero80degrees. All patients were administered oral Yuan Shi Sheng Mai Gu Pian(8pills,3times a day). After2months treatment, we recollected patient’s serum as the study group. We blended pre-intervention and intervention serum samples respectively and applied dimensional electrophoresis and leather analysis technology to construct serum protein spectrum. We aimed to finding out the differential protein which were of statistical significance, and search its function to screen proteins related to pharmacy intervention.2. Clinical research The included patients were the same as the basis research. We detected the change of blood lipid six, Harris Hip Score, and VAS Score in all patients and figured out whether there were statistical significance or not.Objevtive1. Pre-intervention and intervention serum differential protein in SANOH patients who were administered Yuan Shi Sheng Mai Cheng Gu tablet were compared the increase or decrease expression protein via dimensional electrophoresis and mass-spectrometric technique. We tried to ascertain the function of differential protein through bioinformatics, which aimed to reveal the mechanisms and determine its primary effects.2. Total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, apolipoprotein AI, apolipoprotein B, Harris Hip Scores (contained pain, function, range of motion, and deformities), VAS Scores were compared the level change. We aimed to proving the expression of relevant differential protein in our study accorded with lab serological indices as well as observing the therapeutic efficacy of Yuan Shi Sheng Mai Cheng Gu tablet.Results 1.21significant protein points were screened in patients who were administered Yuan Shi Sheng Mai Cheng Gu tablet in the study group.6protein points were appealed increase expression and we divided them as group A, while we defined group B as14protein points which were lowly expressed. When the21protein points were identified, we found5differential protein points which showed great significance through searcher Tools in NCBI database and Bio software.2. The pre-intervention and intervention level of total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, apolipoprotein AI, apolipoprotein B in all patients who were administered Yuan Shi Sheng Mai Cheng Gu Tablet were6.04±1.8and4.36±0.94,1.99±0.84and1.56±0.72,1.29±0.59and1.88±0.36,3.18±0.90and2.94±0.53,1.09±0.46and1.44±0.33,0.85±0.22and0.64±0.31, respectively. The change of total cholesterol, triglyceride, high-density lipoprotein, apolipoprotein AI, apolipoprotein B revealed statistical significance(p<0.05), while low-density lipoprotein revealed no significance(p>0.05). The pre-intervention and intervention values of Harris Hip Scores, function scores, range of motion scores, and VAS Scores in all patients were34.40±4.56and41.2±1.80,34.75±3.67and43.40±2.46,4.33±0.02and4.73±0.02,7.39±0.57and4.00±0.51, respectively. All the reference values showed statistical significance(p<0.01).ConclusionIn patients who were administered Yuan Shi Sheng Mai Cheng Gu Tablet, we found that decrease expression of tetranectin, glutathione peroxidase and apolipoprotein E, and increase expression of apolipoprotein AI and zinc alpha2glycoprotein.Consequently, we concluded that Yuan Shi Sheng Mai Cheng Gu Tablet enables correction of lipid metabolism disorder, strengthen vessels self-protection ability, put off the development of SANFH. It provided chances for the remolding and repairmen of the necrosis area. Yuan Shi Sheng Mai Cheng Gu Tablet can partially correct hyperlipidemia, extremely alleviate pain of SANFH patients, and improve hip function and quality of life. |
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