Study On The Relationship Between Non-traumatic Osteonecrosis Of Femoral Head Of Blood Stasis And Lipid Metabolism Based On AMPK Signal Pathway

Objectives:1.To study the pathogenesis of non-traumatic osteonecrosis of femoral head,the risk factors of non-invasive osteonecrosis,the relationship between non-invasive osteonecrosis and lipid metabolism,AMPK signaling pathway and its relationship with lipid metabolism;2.To conduct epidemiological investigation on the high incidence constitution of NONFH,to further determine the constitution type of NONFH high incidence TCM and the pathogenic factors of high-risk factors,to collect blood samples and detect the related indexes of lipid metabolism of three groups of people,including blood stasis NONFH patients,peaceable NONFH and non blood related healthy volunteers,to obtain the possible specific indexes of lipid metabolism of NONFH patients,and to be the intervention and target of the disease Provide theoretical basis for treatment.Methods:1.In PubMed,CNKI and other authoritative literature retrieval databases,consult the literature related to the pathogenesis,TCM Constitution,AMPK and lipid metabolism of NONFH for discussion;2.Collect the NONFH patients who met the inclusion criteria in orthopaedics department of Gansu TCM hospital from September 2017 to October 2018,and determine the TCM body type,establish the NONFH epidemiological investigation database,sort out and analyze the common TCM Constitution of NONFH Based on the epidemiological study,10 cases of typical blood stasis,10 cases of normal NONFH and 10 cases of non blood related healthy volunteers were randomly selected from the NONFH database.AMPK,FGF21,PAI-1,CPI-17 lipid metabolism related genes were detected by Q-PCR,and western-blot was used at the same time The expression of AMPK,FGF21 and PAI-1 were detected by lot.Results:1.NONFH is mostly found in male patients,with a male to female ratio of 1.3:1.The age of disease is mainly middle-aged people;the age of disease is mostly young and middle-aged people;the right side of bilateral hip joint is mostly found;76.79% of the patients are engaged in heavy physical labor such as agriculture,46.43% of them are under junior high school education(including junior high school education);most of the patients are late patients;the course of disease is long when the patients are hospitalized,with a course of 1-5 years Of them,33.93%,17.86% were alcohol-induced and 32.14% were hormone-induced.Blood stasis,phlegm dampness and Qi deficiency were the most common diseases in single constitution(28.00%,12.00% and 10.00% respectively);the proportion of qi deficiency and yang deficiency constitution was the highest,followed by phlegm dampness;2.The age of onset of blood stasis was 41-50 years,accounting for 50%,and the course of disease was mainly concentrated in 1-5 years,accounting for 57.14%.Sex,hip,nationality,occupation,pathogenic factors,education background were consistent with the general constitution of NONFH.3.The expression of AMPK and PAI-1 gene in patients with blood stasis and NONFH was higher than that in patients with NONFH(P<0.05),and the expression of PAI-1 gene in NONFH was higher than that in normal group.The expression of FGF21 and PAI-1 gene in the three groups was significantly different(P>0.05);4.In terms of protein expression,there was no significant difference in AMPK between the blood stasis group and the normal group(P>0.05),and there was no significant difference between the blood stasis group and the normal group(P<0.05).There was no significant difference among the three groups(P>0.05).There was no significant difference in PAI-1 between the blood stasis group and the normal group(P>0.05).Conclusions:1.NONFH is mainly found in male patients,and the single constitution is characterized by high incidence of blood stasis,Qi deficiency and yang deficiency;the proportion of qi deficiency and yang deficiency constitution is the highest,followed by phlegm dampness;2.The age and course of disease of blood stasis are different from the conclusion of NONFH.Sex,hip,nationality,occupation,pathogenic factors,education background were consistent with the general constitution of NONFH;3.AMPK gene may be one of the regulatory factors of NONFH in blood stasis of lipid metabolism disorder;PAI-1 is not only a possible differential index between NONFH and normal patients,but also a possible specific index of blood stasis and peace.There was no difference in FGF21 and CPI-17 among the three groups;4.In protein expression,AMPK and PAI-1 may be the lipid metabolism specific protein of the blood stasis group compared with the normal group.There was no significant difference in the protein content of FGF21 among the three groups.