Advances of Strategies to Increase the Surface Charge Density of Triboelectric Nanogenerators: A Review

Triboelectric nanogenerators (TENGs) have manifested a remarkable potential for harvesting environmental energy and have the prospects to be utilized for various uses, for instance, self-powered sensing devices, flexible wearables, and marine corrosion protection. However, the potential for further development of TENGs is restricted on account of their low output power that in turn is determined by their surface charge density. The current review majorly focuses on the selection and optimization of triboelectric materials. Subsequently, various methods capable of enhancing the surface charge density of TENGs, including environmental regulation, charge excitation, charge pumping, electrostatic breakdown, charge trapping, and liquid-solid structure are comprehensively reviewed. Lastly, the review is concluded by highlighting the existing challenges in enhancing the surface charge density of TENGs and exploring potential opportunities for future research endeavors in this area.

Improving the Surface Oxygen Vacancy Concentration of Bi2O4 through the Pretreatment of the NaBiO3·2H2O Precursor as a High-Performance Visible Light Photocatalyst

The oxygen-deficient bismuth oxide, Bi₂O₄, synthesized by a typical hydrothermal method using commercial NaBiO₃·2H₂O as a raw material only has a relatively low concentration of surface oxygen vacancies (OVs). How to improve the visible light photocatalytic performance of Bi₂O₄ via tuning its surface OV concentration is still a huge challenge. In this study, improving the surface OVs of Bi₂O₄ was successfully realized through the pretreatment of commercial NaBiO₃·2H₂O, including thermal treatment in air and hydrothermal treatment in 10 M NaOH solution, forming NaBiO₃·xH₂O intermediate products first, and then hydrothermal preparation of Bi₂O₄ target products using NaBiO₃·xH₂O instead of commercial NaBiO₃·2H₂O as the precursor. The enhanced surface OV content not only narrows the band gap of Bi₂O₄ and thus extends its optical response range but also captures more photoexcited electrons and thus increases the charge carriers' separation efficiency and prolongs the charge carriers' lifetime of Bi₂O₄. Among the above-mentioned two pretreatment methods, the effects of the hydrothermal pretreatment are superior to those of the thermal treatment, involving the increase of surface OVs, the optical harvesting capacity, and the charge carriers' separation efficiency. Accordingly, Bi₂O₄ prepared by the hydrothermal pretreatment route exhibits the optimal visible light catalytic performance toward the removal of methyl orange (MO) and phenol due to its most abundant surface OV concentration, which is 2.59 times and 4.26 times higher than that of Bi₂O₄ synthesized directly by the commercial NaBiO₃·2H₂O route, respectively. Holes (h⁺) and superoxide radicals (^•O₂^-) are identified as the main active species, while singlet oxygen (¹O₂) and hydroxyl radicals (^•OH) are verified as the second and third important active species for organic pollutant removal, respectively. This work has developed a novel strategy to promote the catalytic performance of single Bi₂O₄ induced by the enhanced surface OV concentration through the pretreatment of the precursor, commercial NaBiO₃·2H₂O.

An Energy Harvester Coupled with a Triboelectric Mechanism and Electrostatic Mechanism for Biomechanical Energy Harvesting

Energy-harvesting devices based on a single energy conversion mechanism generally have a low output and low conversion efficiency. To solve this problem, an energy harvester coupled with a triboelectric mechanism and electrostatic mechanism for biomechanical energy harvesting is presented. The output performances of the device coupled with a triboelectric mechanism and electrostatic mechanism were systematically studied through principle analysis, simulation, and experimental demonstration. Experiments showed that the output performance of the device was greatly improved by coupling the electrostatic induction mechanisms, and a sustainable and enhanced peak power of approximately 289 μW was produced when the external impedance was 100 MΩ, which gave over a 46-fold enhancement to the conventional single triboelectric conversion mechanism. Moreover, it showed higher resolution for motion states compared with the conventional triboelectric nanogenerator, and can precisely and constantly monitor and distinguish various motion states, including stepping, walking, running, and jumping. Furthermore, it can charge a capacitor of 10 μF to 3 V within 2 min and light up 16 LEDs. On this basis, a self-powered access control system, based on gait recognition, was successfully demonstrated. This work proposes a novel and cost-effective method for biomechanical energy harvesting, which provides a more convenient choice for human motion status monitoring and can be widely used in personnel identification systems.

Impact of high bleeding risk criteria on short- and long-term outcomes in patients with acute myocardial infarction

Background

The Academic Research Consortium (ARC) proposed the new definition of high bleeding risk (HBR) criteria. It remains unknown about the prevalence and the impact of HBR on clinical outcome after acute myocardial infarction (AMI).

Purpose

To assess the prevalence and the impact of HBR on short- and long-term outcomes in patients with AMI.

Methods

Between January 2015 and January 2018, 412 patients with AMI underwent coronary angiography within 24 hours after the onset of chest pain. According to HBR criteria proposed by ARC, we divided patients into 2 groups; HBR and non-HBR group. We considered a patient HBR if the patient met at least 1 major criteria or 2 minor criteria. Major criteria included severe CKD (eGFR<30 ml/min), severe anemia (Hgb<11 g/dl), active cancer, and the use of oral anticoagulant drug. Minor criteria included high age (≥75), moderate CKD (eGFR 30–59 ml/min), moderate anemia (Hgb 11–12.9 g/dl for men and 11–11.9 g/dl for women). Kaplan-meier method was used to compare long-term outcome of HBR and non-HBR group. Major adverse cardiovascular events (MACE) were defined as all-cause death, non-fetal MI, and stroke.

Results

Patients with HBR were found in 37% of patients with AMI. In-hospital mortality (11.3% vs 4.2%, p=0.008) and MACE rate was significantly higher in HBR than non-HBR group (Figure). HBR group was associated with higher all-cause death (15.7% vs 2.5%, p<0.0001) and intracranial bleeding (4.8% vs 0.5%, p=0.02) than non-HBR group, although the incidence of non-fetal MI was comparable between two groups (7.6% vs 8.5%, p=0.76).

Conclusions

AMI patients with HBR were associated with worse outcomes both short- and long-term.

Kaplan-Meier curves for MACE

Funding Acknowledgement

Type of funding source: None

Design on a Novel Titanium Dioxide Irregularly Distributed Bragg Reflector for Thin Film Silicon Solar Cells

Titanium dioxide, which leads an excellent optical performance, is proposed to design irregularly distributed Bragg reflector (IDBR) through theoretical simulation as well as experimental verification. Firstly, a primary distributed Bragg reflector (DBR) model with the titanium dioxide serving as low reflection layer in, and amorphous silicon as high reflection layer is analyzed. The titanium dioxide DBR shows much enhanced reflection bandwidth relative to the DBR with silicon dioxide. A further study suggests that a traditional titanium dioxide IDBR demonstrate much enhanced performance versus the silicon dioxide IDBR with similar structure. Besides, the reflection bandwidth of the IDBR, especially in the high wavelength range, is dramatically promoted with respect to the DBR. Finally, a novel gradient IDBR model is developed. The simulation results reveal a higher reflection bandwidth of the titanium dioxide gradient IDBR than the silicon dioxide one. The reflectance of the titanium dioxide gradient IDBR is up to 90% in a range by 300 to 1450 nm. And, the reflection bandwidth of the gradient IDBR is much improved respect to the traditional IDBR. It seems that the titanium dioxide gradient IDBR could be an efficient selection for the thin film silicon solar cells. Finally, the gradient IDBR were fabricated via plasma enhanced chemical vapor deposition (PECVD) on a silicon wafer. A further test demonstrates a reflectance over 95% in the range from 400 to 1400 nm, and verifies the simulation results.

Inverted Planar Perovskite Solar Cells Based on NiOx Nano Film with Enhanced Efficiency and Stability

The organometal halide perovskite (OHP) materials have attracted much attention throughout the world due to their superb optoelectronic properties. Tremendous progress has been made in the OHP based solar cells with increased efficiency from 3.8% to 24.2% within the last decade, benefiting from efforts in the photovoltaic field. However, all the OHP solar cells with highest efficient are based on a normal mesoporous structure with TiO2 at the bottom, which needs high temperature process. The inverted planar structure OHP solar cells based on PEDOT:PSS suffer from low efficiency (lower than 15%) and inferior stability due to degradation of PEDOT:PSS in ambient air. Herein, we employed sol-gel method to fabricate a NiO_x nano film as the hole transporting layer for inverted OHP solar cells. The device performance based on PEDOT:PSS and NiO_x were systematically investigated. It was found that the perovskite films on NiO_x film had larger grain size and thus lower defects) density. The Capacitance-Voltage measurement indicated that the device based on NiO_x exhibited larger built-in potential, which significantly enhanced the open-circuit potential of the OHP solar cells. Furthermore, the solar cell based on NiO_x nano film exhibited excellent stability compared with the PEDOT:PSS based device, due to robust property of NiO_x in ambient air.

P4760New minimally invasive and tailor-made strategy for cryoballoon ablation in patients with paroxysmal atrial fibrillation

Background

Currently, cryoballoon ablation (CBA) has proven to be highly effective in achieving free from atrial fibrillation (AF), especially paroxysmal AF. However, the optimal freezing protocol for each patient to achieve successful pulmonary vein isolation by only CBA is still uncertain. The aim of this study was to evaluate the clinical implications of a reduction in the freezing duration (<180s) during CBA guided by the time to target temperature.

Methods

From November 2015 to August 2018, 286 consecutive paroxysmal AF patients undergoing CBA were enrolled. We compared 107 patients undergoing a tailor-made CBA procedure (Group A; August 2017-August 2018) to 179 patients with a standard CBA procedure (Group B; November 2015–July 2017). In Group A, the freezing duration was reduced to 150s when the temperature reached ≤−40°C within 40s. Furthermore, we reduced it to 120s when it reached ≤−50°C within 60s. In the other patients, the freezing time was 180s except for excessive freezing over −60°C and/or emergent situations while monitoring the esophageal temperature and for phrenic nerve injury as in Group B.

Results

The baseline clinical characteristics were similar between two groups. In Group A, 89 patients (83%) underwent CBA with a reduction in the freezing time. The rate of having reduction time in left inferior PV (LIPV) and right inferior PV (RIPV) was lower compared with left superior PV (LSPV) and right superior PV (RSPV) (respectively 17%, 29%, 56%, and 63.5%). However, for right inferior PV, in 31 patients having the reduced freezing time, none of them required touch-up ablation. Although the procedure time and frequency of touch-up ablation did not differ between the 2 groups, total freezing time for each PV was significantly shorter in Group A than Group B as shown in figure (LSPV: 164±28s vs. 216±67s; p<0.001, LIPV: 187±44s vs. 218±69s; p<0.001, RSPV: 147±31s vs. 192±51s; p<0.001, RIPV: 180±50 vs. 218±73s; p<0.001). The AF free survival rate during the follow-up period (356±167 days) was similar between the 2 groups (log-rank test, p=0.38). Furthermore, the complication rate was similar 2 groups.

The freezing time for each PV

Conclusion

The safety and efficacy of the new tailor-made CBA strategy were non-inferior to the standard procedure. This study showed that the unnecessary freezing time could be reduced in most of paroxysmal AF patients.

P2694Early and late restenosis after excimer laser coronary angioplasty and paclitaxel-coated balloon combination therapy for drug-eluting stent restenosis

Background

Drug-eluting stent restenosis (DES-ISR) is associated with poorer outcomes than those of bare-metal stent restenosis after treatment with paclitaxel-coated balloon (PCB), and late restenosis after PCB angioplasty for DES-ISR is a residual problem. Excimer laser coronary angioplasty (ELCA) is thought to be advantageous for ISR treatment by removing neointima. However, whether the combination of ELCA and PCB angioplasty is more effective than the use of PCB only angioplasty in DES-ISR has not been studied so far.

Purpose

We evaluated the efficacy of ELCA and PCB combination therapy for DES-ISR at mid-and late-term after revascularization.

Methods

From January 2014 to March 2016, 166 DES-ISR lesions were treated with ELCA and no-ELCA prior to PCB. Two serial angiographic follow-ups were planned for the patients (at 6–12 and 18–24 months after procedure). Acute procedural and follow-up angiographic results were assessed by quantitative coronary angiography. ELCA and no-ELCA group included 74 lesions and 92 lesions, respectively.

Results

There was no significant difference between the two groups in the clinical characteristics except the prevalence of hemodialysis, the rate of first-generation DES (37.9% vs 36.8%, p=0.897), previous stent size (2.90±0.39 mm vs 2.77±0.39 mm, p=0.063), and reference vessel diameter (2.65±0.46 mm vs 2.60±0.65 mm, p=0.593). Early follow-up angiography was performed in 66 lesions (89.1%) of ELCA group, and was done in 76 lesions (82.6%) of no-ELCA group. In the ELCA group, percentage diameter stenosis (%DS) just after procedure and at 6–12 months later were significantly smaller than those of no-ELCA group. Besides, target lesion revascularization (TLR) rate at 6–12 months after procedure was tended to be lower in the ELCA group. Late follow-up angiography was performed for 93 lesions (81.6%) of the remaining 114 lesions (excluding TLR lesion), late restenosis was found 9 lesions (18.6%) in the ELCA group and 11 lesions (24.4%) in the no-ELCA group (p=0.504). Late luminal loss was similar in both groups (0.37±0.71 mm vs 0.24±0.82 mm, p=0.438), and %DS at 12–18 months after revascularization was not different between the two groups.

Changes of %DS and TLR rate

Conclusions

%DS in the ELCA group was smaller at just after procedure and the advantage was kept even after 1-year. However, late restenosis and TLR at 2-year after revascularization for DES-ISR could not be reduced by ELCA and PCB combination therapy.

P1831Prediction of cardiovascular events by atheromatous plaques detected by non-obstructive general angioscopy: two-year results of EAST-NOGA Registry

Background

Non-obstructive general angioscopy (NOGA) has revealed the intimal damages or atheromatous plaques as well as its spontaneous rupture of the aorta. Recent study revealed that plaque debris or different size of cholesterol crystals were detected in the blood above the spontaneous ruptured aortic plaque observed by NOGA and these plaque materials might cause the peripheral organ damages as the embolic source. These various morphological changes may cause the acute aortic events or atheroembolic events on the peripheral organs, such as brain, kidney, peripheral artery and so on.

Purpose

EAST-NOGA (Evaluation of AtheroSclerotic and rupture events by Non-Obstructive General Angioscopy) is a multi-center prospective observational study to assess the relationship between the findings of NOGA and future cardiovascular events.

Methods

Five hundred and seventy-seven patients with atherosclerotic cardiovascular disease who underwent NOGA study. The major cerebrocardiovascular events including cardiovascular death, non-fatal myocardial infarction, non-fatal cerebral infarction, and acute aortic syndrome were accumulated during the 2-year follow-up after NOGA study.

Results

The median number of aortic atheromatous plaques was 6 [IQR: 3–12]. A total of 514 patients were followed up (89.1%). The mean follow-up duration was 757±120 days. Major adverse cardiovascular events developed in 23 (4.5%) during 2 years follow-up. Patients with MACE and cerebral infarction, had significantly greater number of aortic atheromatous plaques (11 [5–19] vs. 6 [3–11], p<0.001, 12 [4–20] vs. 6 [3–12], p=0.014, respectively). In a univariate analysis, the number of aortic atheromatous plaques and ruptured plaque were significant predictors of MACE (HR: 1.09 95% confidence interval 1.05–1.14, p<0.001) and (HR: 1.12, 95% confidence interval 1.02–1.23, p=0.02). In a multivariate logistic analysis, the number of aortic atheromatous plaques is one of the independent predictors of MACE (HR 1.05, 95% confidence interval 1.00–1.10, p=0.032).

Conclusion

The number of atheromatous plaques identified by NOGA has a significant relation to the onset of cerebral infarction, which suggest the atheromatous plaque were vulnerable and ruptured spontaneously, then cause the aortogenic cerebral infarction. The NOGA study would be useful for predicting the futured atheroembolic events.

Acknowledgement/Funding

None

Zoledronic acid suppresses callus remodeling but enhances callus strength in an osteoporotic rat model of fracture healing

MINI-ABSTRACT

In this study, we demonstrated that the use of zoledronic acid does not impair fracture healing, but results in superior callus size and resistance at the fracture site, which could be the consequence of a lower rate of bone turnover due to its anti-catabolic effect.

OBJECTIVE

To investigate the effect of inhibition of bone remodeling by the bisphosphonate, zoledronic acid, on callus properties in an osteoporotic rat model of fracture healing.

METHODS

Ovariectomized (OVX) rats were randomly divided into four treatment groups (n=24 per group): saline control (CNT); and three systemic zoledronic acid-injected groups (0.1mg/kg), administered 1 day (ZOLD1), 1 week (ZOLW1), and 2 weeks (ZOLW2) after fracture. Rats were killed at either 6 or 12 weeks postoperatively. Postmortem analyses included radiography, microcomputed tomography, histology, histomorphometry, biomechanical tests, and nanoindentation tests.

RESULTS

Treatment with zoledronic acid led to a significant increase in trabecular bone volume within the callus, as well as in callus resistance, compared to those in the saline control rats; delayed administration (ZOLW2) reduced intrinsic material properties, including ultimate stress and elastic modulus, and microarchitecture parameters, including bone volume/total volume (BV/TV), trabecular thickness (Tb.Th), and connectivity density (Conn.D), compared with ZOLD1 at 12 weeks after surgery. OVX had a negative effect on the progression of endochondral ossification at 6 weeks. Zoledronic acid administration at an early stage following fracture may bind to early callus, and thus not affect subsequent callus formation and endochondral ossification, while delayed administration (ZOLW2) mildly suppresses bony callus remodeling.

CONCLUSION

The superior results obtained with zoledronic acid (ZOLD1, ZOLW1, and ZOLW2) compared to CNT in terms of callus size and resistance could be the consequence of a lower rate of bone turnover at the fracture site due to the anti-catabolic effect of zoledronic acid. Mild suppression of callus remodeling by delayed administration did not impair the initial phase of the fracture healing process.

Production and repair of implant-induced microdamage in the cortical bone of goats after long-term estrogen deficiency

SUMMARY

By using an ovariectomized goat model, we found that estrogen depletion decreases bone quality and makes it susceptible to screw-induced mechanical microdamage. Both diffuse microdamage and linear cracks accumulated up to 3 weeks after screw implantation, and the microdamage was repaired gradually after 4-8 months.

INTRODUCTION

The aim of this study was to observe the effect of long-term estrogen deficiency on the creation and repair of microdamage in cortical bone adjacent to bone screw.

METHODS

Cortical bone screws were placed in the tibial diaphyses 28 months after ovariectomy (OVX) or sham operation (Sham-Op) in female goats. The goats were euthanized at 0 day, 21 days, 4 months, and 8 months after screw implantation. Microdamage morphology and repair were examined in peri-screw bone using histomorphometric method, and the nanomechanical properties of peri-screw bone were examined with nanoindentation testing.

RESULTS

Tibiae from ovariectomized goats in which screws had been placed had significantly higher levels of diffuse microdamage and significantly more linear cracks than those from sham goats, and the diffuse microdamage was more obvious than linear cracks in the region adjacent to the implant. Both diffuse microdamage and linear cracks accumulated up to day 21 and then gradually repaired at 4 and 8 months after surgery. The trend for bone remodeling in each group was consistent with changes in the level of microdamage. Nanoindentation testing showed that both elastic modulus and hardness in peri-screw bone were significantly decreased in OVX group compared to Sham-Op group. The hardness and elastic modulus also showed a downward trend up to 4 months after screw implantation and then exhibited some recovery after 8 months.

CONCLUSIONS

Estrogen depletion decreases bone quality and makes it vulnerable to screw-induced mechanical damage, which may compromise the initial stability of an orthopedic implant.

Coffee, tea, and the risk of hip fracture: a meta-analysis

The present meta-analysis shows no clear association between coffee consumption and the risk of hip fractures. There was a nonlinear association between tea consumption and the risk of hip fracture. Compared to no tea consumption, drinking 1-4 cups of tea daily was associated with a lower risk of hip fracture.

INTRODUCTION

Prospective cohort and case-control studies have suggested that coffee and tea consumption may be associated with the risk of hip fracture; the results have, however, been inconsistent. We conducted a meta-analysis to assess the association between coffee and tea consumption and the risk of hip fracture.

METHODS

We performed systematic searches using MEDLINE, EMBASE, and OVID until February 20, 2013, without limits of language or publication year. Relative risks (RRs) with 95% confidence intervals (CI) were derived using random-effects models throughout all analyses. We conducted categorical, dose-response, heterogeneity, publication bias, and subgroup analyses.

RESULTS

Our study was based on 195,992 individuals with 9,958 cases of hip fractures from 14 studies, including six cohort and eight case-control studies. The pooled RRs of hip fractures for the highest vs. the lowest categories of coffee and tea consumption were 0.94 (95% CI 0.71-1.17) and 0.84 (95% CI 0.66-1.02), respectively. For the dose-response analysis, we found evidence of a nonlinear association between tea consumption and the risk of hip fracture (p(nonlinearity) < 0.01). Compared to no tea consumption, 1-4 cups of tea per day may reduce the risk of hip fracture by 28% (0.72; 95% CI 0.56-0.88 for 1-2 cups/day), 37% (0.63; 95% CI 0.32-0.94 for 2-3 cups/day), and 21% (0.79; 95% CI 0.62-0.96 for 3-4 cups/day).

CONCLUSIONS

We found no significant association between coffee consumption and the risk of hip fracture. A nonlinear association emerged between tea consumption and the risk of hip fracture; individuals drinking 1-4 cups of tea per day exhibited a lower risk of hip fractures than those who drank no tea. The association between 5 daily cups of tea, or more, and hip fracture risk should be investigated.

Dexamethasone shifts bone marrow stromal cells from osteoblasts to adipocytes by C/EBPalpha promoter methylation

Dexamethasone (Dex)-induced osteoporosis has been described as the most severe side effect in long-term glucocorticoid therapy. The decreased bone mass and the increased marrow fat suggest that Dex possibly shifts the differentiation of bone marrow stromal cells (BMSCs) to favor adipocyte over osteoblast, but the underlying mechanisms are still unknown. In this paper, we established a Dex-induced osteoporotic mouse model, and found that BMSCs from Dex-treated mice are more likely to differentiate into adipocyte than those from control mice, even under the induction of bone morphogenetic protein-2 (BMP2). We also discovered both in vitro and in vivo that the expression level of adipocyte regulator CCAAT/enhancer-binding protein alpha (C/EBPalpha) is significantly upregulated in Dex-induced osteoporotic BMSCs during osteoblastogenesis by a mechanism that involves inhibited DNA hypermethylation of its promoter. Knockdown of C/EBPalpha in Dex-induced osteoporotic cells rescues their differentiation potential, suggesting that Dex shifts BMSC differentiation by inhibiting C/EBPalpha promoter methylation and upregulating its expression level. We further found that the Wnt/beta-catenin pathway is involved in Dex-induced osteoporosis and C/EBPalpha promoter methylation, and its activation by LiCl rescues the effect of Dex on C/EBPalpha promoter methylation and osteoblast/adipocyte balance. This study revealed the C/EBPalpha promoter methylation mechanism and evaluated the function of Wnt/beta-catenin pathway in Dex-induced osteoporosis, providing a useful therapeutic target for this type of osteoporosis.

Total hip replacement for developmental dysplasia of the hip with more than 30% lateral uncoverage of uncemented acetabular components

In developmental dysplasia of the hip (DDH), a bone defect is often observed superior to the acetabulum after the reconstruction at the level of the true acetabulum during total hip replacement (THR). However, the essential amount of uncemented acetabular component coverage required for a satisfactory outcome remains controversial. The purpose of this study was to assess the stability and function of acetabular components with a lack of coverage > 30% (31% to 50%). A total of 760 DDH patients underwent THR with acetabular reconstruction at the level of the true floor. Lack of coverage above the acetabular component of > 30% occurred in 56 patients. Intra-operatively, autogenous morcellised bone grafts were used to fill the uncovered portion. Other than two screws inserted through the acetabular shell, no additional structural supports were used in these hips. In all, four patients were lost to follow-up. Therefore, 52 patients (52 hips, 41 women and 11 men) with a mean age of 60.1 years (42 to 78) were available for this study at a mean of 4.8 years (3 to 7). There were no instances of prosthesis revision or marked loosening during the follow-up. The Harris hip score improved from a mean of 40.7 points (sd 12.2) pre-operatively to 91.1 (sd 5.0) at the last follow-up. Radiological analysis with medical imaging software allowed us to calculate the extent of the uncoverage in terms of the uncovered arc of the implant as viewed on the anteroposterior pelvic radiograph. From this we propose that up to 17 mm of lateral undercoverage in the presence of a stable initial implantation in the presence of bone autografting, with an inclination angle of the acetabular component between 40° and 55°, is acceptable. This represents undercoverage of ≤ 50%.

Cite this article: Bone Joint J 2013;95-B:1178–83.

Osteoblastogenesis regulation signals in bone remodeling

Bone remodeling is essential for adult bone homeostasis. The failure of this process often leads to the development of osteoporosis, a present major global health concern. The most important factor that affects normal bone remodeling is the tightly controlled and orchestrated regulation of osteoblasts and osteoclasts. The present review summarized the recent discoveries related to osteoblast regulation from several signals, including transforming growth factor-β, bone morphogenetic proteins, Wnt signal, Notch, Eph-Ephrin interaction, parathyroid hormone/parathyroid hormone-related peptide, and the leptin-serotonin-sympathetic nervous systemic pathway. The awareness of these mechanisms will facilitate further research that explores bone remodeling and osteoporosis. Future investigations on the endogenous regulation of osteoblastogenesis will increase the current knowledge required for the development of potential drug targets in the treatment of osteoporosis.

The first multicenter and randomized clinical trial of herbal Fufang for treatment of postmenopausal osteoporosis

This multicenter and randomized clinical trial showed that daily oral herbal formula Xian Ling Gu Bao (XLGB) was safe in postmenopausal women over a 1-year treatment. Those patients (n ∼ 50) treated with XLGB at the conventional dose demonstrated a statistically significant increase in dual-energy X-ray absorptiometry (DXA) bone mineral density (BMD) at lumbar spine at 6 months and a numerically increased BMD at 12 months.

INTRODUCTION

The aim of this study was to examine the safety and efficacy of a herbal formula XLGB in postmenopausal women (ChiCTR-TRC-00000347).

METHODS

One hundred eighty healthy postmenopausal women (≥60 years old) with BMD T-score ≤ -2.0 (lumbar spine or femoral neck) were recruited from four clinical centers to receive low-dose (conventional dose) XLGB (L-XLGB group, 3 g/day, n = 61) or high-dose XLGB (H-XLGB group, 6 g/day, n = 58) or placebo (CON group, n = 61). Women received daily calcium (500 mg) and vitamin D (200 IU) supplementation. Primary endpoints were lumbar spine BMD and safety; secondary endpoints were femoral neck BMD and bone turnover markers measured at baseline and at 6 and 12 months.

RESULTS

Of 180 women recruited, 148 completed the study. The compliance in each group was comparable. Prominent adverse events were not observed in either group. In the L-XLGB group at 6 months, lumbar spine BMD by DXA increased significantly from baseline (+2.11% versus CON +0.58%, p < 0.05), but femoral neck BMD did not; at 12 months, BMD in the L-XLGB group decreased from 6-month levels yet remained higher than baseline, but without difference from the CON group. There was no dose-dependent response. Bone turnover marker levels declined during the first 6 months after XLGB treatment. There was no significant difference in the overall incidence of side effects among treatment and control groups.

CONCLUSION

XLGB over 1-year treatment at the conventional dose demonstrated safe and only a statistically significant increase in BMD at lumbar spine at 6 months in postmenopausal women.

Association of single-nucleotide polymorphisms in HLA class II/III region with knee osteoarthritis

OBJECTIVE

A genome-wide association study and a replication using Japanese, Spanish and Greek Caucasian populations have recently indicated two single-nucleotide polymorphisms (SNPs) (rs7775228 and rs10947262) associated with knee Osteoarthritis (OA) susceptibility. We have further evaluated the association in knee OA subjects from Han Chinese and Australian Caucasian origin.

METHODS

Two independent case-control association studies were performed using Han Chinese and Australian Caucasian populations. The two SNPs were genotyped in patients who had primary symptomatic knee OA with radiographic confirmation and/or received total knee replacement surgery as well as in matched controls. They were subjected to statistic analyses.

RESULTS

A total of 991 OA patients and 1536 controls were genotyped. No significant difference was detected in genotype or allele frequencies of the two SNPs between knee OA and control groups in the two populations (all P>0.05). The association was also negative even after stratification by sex, body mass index (BMI) and Kellgren/Lawrence scores. The significant heterogeneity was detected between Chinese and Japanese (both P<0.05). In the Caucasian samples, no significant heterogeneity was detected (both P>0.05). The result of meta-analysis showed significant association between knee OA and rs10947262 in total subjects [summary OR=1.26, 95%confidence intervals (CI)=1.07-1.27, P=3 × 10(-8)] and in Caucasian samples (summary OR=1.28, 95%CI=1.04-1.57, P=0.02).

CONCLUSION

We demonstrated no association between the two SNPs in human leukocyte antigen (HLA) class II/III region and knee OA in Han Chinese population. A significant association was detected between SNP rs10947262 and knee OA in Caucasian subjects. Further replication studies are required to identify the impact of controversial association.

The glycoprotein Ibalpha-von Willebrand factor interaction induces platelet apoptosis

BACKGROUND

The interaction of glycoprotein (GP) Ibalpha with von Willebrand factor (VWF) initiates platelet adhesion, and simultaneously triggers intracellular signaling cascades leading to platelet aggregation and thrombus formation. Some of the signaling events are similar to those occurring during apoptosis, however, it is still unclear whether platelet apoptosis is induced by the GPIbalpha-VWF interaction.

OBJECTIVES

To investigate whether the GPIbalpha-VWF interaction induces platelet apoptosis and the role of 14-3-3zeta in apoptotic signaling.

METHODS

Apoptotic events were assessed in platelets or Chinese hamster ovary (CHO) cells expressing wild-type (1b9) or mutant GPIb-IX interacting with VWF by flow cytometry or western blotting.

RESULTS

Ristocetin-induced GPIbalpha-VWF interaction elicited apoptotic events in platelets, including phosphatidylserine exposure, elevations of Bax and Bak, gelsolin cleavage, and depolarization of mitochondrial inner transmembrane potential. Apoptotic events were also elicited in platelets exposed to pathologic shear stresses in the presence of VWF; however, the shear-induced apoptosis was eliminated by the anti-GPIbalpha antibody AK2. Furthermore, apoptotic events occurred in 1b9 cells stimulated with VWF and ristocetin, but were significantly diminished in two CHO cell lines expressing mutant GPIb-IX with GPIbalpha truncated at residue 551 or a serine-to-alanine mutation at the 14-3-3zeta-binding site in GPIbalpha.

CONCLUSIONS

This study demonstrates that the GPIbalpha-VWF interaction induces apoptotic events in platelets, and that the association of 14-3-3zeta with the cytoplasmic domain of GPIbalpha is essential for apoptotic signaling. This finding may suggest a novel mechanism for platelet clearance or some thrombocytopenic diseases.

Expansion of CD14+CD16+ peripheral monocytes among patients with aseptic loosening

OBJECTIVE AND DESIGN

In this study, we have investigated the relevance of peripheral blood inflammatory CD14(+)CD16(+) monocytes phenotype to patients with aseptic loosening (AL).

MATERIAL AND TREATMENT

Immunophenotypes of monocytes were examined among patients with AL (n = 43), patients with mechanical loosening (ML, n = 30), patients with stable implant (SI, n = 16), and patients with osteoarthritis (OA, n = 17) using flow cytometry.

METHODS

Immunological assay was used to measure TNF-alpha and IL-1 beta levels in both sera and culture media of implant wear stimulated CD14(+)CD16(+) and CD14(++)CD16(-) monocytes. Periprosthetic tissues were collected during surgery for histological assessment.

RESULTS

The frequency of CD14(+)CD16(+) monocytes showed significant increase in AL patients than in ML, SI, and OA patients. A positive association was found between the subpopulation of CD14(+)CD16(+) monocytes and plasma TNF-alpha and IL-1 beta level in AL patients. Furthermore, a positive correlation existed between the subpopulation of CD14(+)CD16(+) monocytes and the total histopathology score.

CONCLUSION

The results indicate that CD14(+)CD16(+) monocytes represent a sensitive marker for the disease activity of AL, and may serve as an effective prognostic index to identify total joint replacement recipients who are at increased risk for osteolysis and progression of AL.

Inhibition of the development of collagen-induced arthritis in Wistar rats through vagus nerve suspension: a 3-month observation

OBJECTIVE AND DESIGN

In this study, we have investigated the effects of vagus nerve suspension in a rat model of collagen-induced arthritis (CIA) .

MATERIALS AND TREATMENT

CIA was induced in male Wistar rats and vagus nerve suspension or sham operation was performed on day 10 after the second immunization. All rats were monitored for macroscopic signs of clinical arthritis and cytokine titres within 2 months after the second immunization. Radiological and histological examination were performed 3 months after the second immunization.

RESULTS

Rats subjected to vagus nerve suspension (the test group) showed nerve activities that resemble electrical stimulation of the vagus nerve in the control group. Compared to control, the test group had reduced soft-tissue swelling, arthritic scores, TNF-alpha level and Collagen-II antibody titre, throughout the course of the experiment. Sham operation produced similar suppression on the CIA symptoms as the test group but most of the effects produced by sham operation subsided after 27 or 35 days.

CONCLUSION

Vagus nerve suspension is a novel approach to achieve sustained long-term stimulation of the vague nerve. This procedure can suppress the development of CIA in rats.

Synaptonemal complex analysis of hybrid and purebred water buffaloes (Bubalus bubalis)

The morphology of the synaptonemal complex (SC) in river (2n = 50) and swamp (2n = 48) water buffaloes and their hybrids, was studied by electron microscopic analysis. In 2n = 49 hybrids, F2 and backcrosses the formation and pairing behaviour of a trivalent at zygotene-pachytene confirmed that river and swamp buffaloes differ by a centromere-to-telomere (C-T) tandem fusion. While 29% of spermatocytes from a purebred river buffalo and 16% from a purebred swamp buffalo had pairing abnormalities, a significantly higher frequency of abnormalities (48-72%) was recorded in F1, F2, and backcrosses with 2n = 48, 49 or 50. Highest abnormality frequencies occurred in 2n = 49 bulls. Abnormal pairing configurations often resulted from interactions between unpaired chromosome axes or segments. Zygotene-pachytene meiotic progress appeared delayed in hybrid bulls, and the frequency of SC abnormalities decreased from XY type I substage to type V substage. The variation in SC abnormality data from hybrids was consistent with the levels of sperm abnormality previously reported.

The Sma I polymorphism in the von Willebrand factor gene associated with acute ischemic stroke

The von Willebrand factor (vWF) is a highly multimerized glycoprotein that promotes platelet adhesion and aggregation at a high shear rate, and also acts as a carrier of coagulation factor VIII. vWF has been identified as a risk factor for recurrent myocardial infarction in the general population. It has been reported that two polymorphisms of vWF gene promoter and the Thr789Ala polymorphism in vWF gene are associated with arterial thrombosis. The Sma I polymorphism is located in intron 2 of vWF gene. The relevance of this polymorphism to thrombotic disease was investigated by genotypic identification in two case-control studies: 107 patients with acute ischemic stroke, 49 patients with acute myocardial infarction (AMI), and 113 health controls age- and race-matched for each patient. Twenty-eight (26.2%) of the 107 patients with acute ischemic stroke, 8 (16.3%) of 49 patients with AMI, and 11 (9.7%) of 113 controls were found to be homozygous for CC genotype, respectively. The prevalence of the CC genotype in acute ischemic stroke was significantly higher than that of the normal controls (odds ratio [OR]=3.29, 95% confidence interval [CI]=1.54-7.01,.01>P>.001). However, the prevalence of the CC genotype in AMI was not significantly different from that of the normal controls (OR=1.81, 95% CI=0.68-4.82,.30>P>.20). Plasma vWF:Ag was also determined by enzyme-linked immunosorbent assay (ELISA) on the frozen plasma of 122 subjects. The mean plasma vWF:Ag levels of the controls, patients with acute ischemic stroke, and AMI were 0.468, 0.584, and 0.783 U/ml, respectively. The mean level of plasma vWF:Ag did not differ significantly between controls and patients with acute ischemic stroke (P=.195), but had significantly difference between controls and patients with AMI (P=.001). No association was found between the Sma I polymorphism and vWF plasma levels in controls, patients with acute ischemic stroke, or the AMI group (one-way ANOVA, P=.323, P=.315, P=.96). Results show that the Sma I polymorphism is strongly associated with increased risk of acute ischemic stroke, however, no association was observed between this polymorphism and AMI. This polymorphism of vWF may represent a newly identified risk factor for acute ischemic stroke in Chinese. Whether it is the real functional variant associated with acute ischemic stroke remains to be elucidated.

[The development and application of computer-aided bone histomorphometry system]

The aim of this study is to develop a Computer-aided Bone Histomorphometry System. The method is based on the Micro-graphical Digital System composed of microscope, digital camera, computer and related programs. The methodology was developed to measure the basic data on each image of visual field of hard bone tissue with computer-assistance. Following this, the parameters of bone volume, bone structure and bone metabolism were calculated based on the standardization of bone histomorphometry. Such method has been used in the experimental and clinical studies of osteoporosis to predict the fracture risk and evaluate the drug effect.

A histomorphometric and molecular study on stress adaptability of freeze-dried bone allograft

OBJECTIVE

To Investigate stress adaptability of freeze-dried bone allograft.

METHODS

Cortical and cancellous allograft were transplanted to each side of the midshaft diaphyseal ulna in two groups of 28 animals. The left transplanted allograft was free from fixation and bore a normal physiological load, while the right transplanted allograft was protected from loading by a simple external fixator and bore less load. Animals were sacrificed at the 2nd, 4th, 8th, 16th week after transplantation and specimens were taken out for bone histomorphometry studies and analysis of collagen gene expression by in situ cDNA-mRNA hybridization.

RESULTS

Labeled surface(LS) and bone mineral apposition rate(MAR) of the normally loaded graft-host bone interface were significantly higher than that of the less loaded side at the 4th, 8th, 16th week after transplantation. Parameters reflecting the internal repair process of the allograft, such as LS in cortical and cancellous bone or MAR in cortical bone of the normally loaded side were significantly higher than those of the less loaded side at the 16th week after transplantation. The result of in situ hybridization indicated that more osteoblast-like cells expressing the type I collagen gene were found in the interface or interior of normally loaded grafts.

CONCLUSION

The stimulus of physiologic load can accelerate the early union of allograft-host bone interface and later new bone creep substitution to the necrotic allograft.

[The Rsa I and Sma I polymorphisms in the von Willebrand factor gene discrimination by hybridization with oligonucleotide arrays]

OBJECTIVE

To develop a new assay for the Rsa I and Sma I polymorphisms (single nucleotide polymorphism, SNP) in the von Willebrand factor gene detection that utilizes oligonucleotide arrays (DNA chips) on glass supports. Expoloring the association of the RsaI and SmaI polymorphisms in the von Willebrand factor gene with thrombosis in Chinese.

METHODS

Allele-specific oligonucleotides are covalently immobilized on glutaradehyde derivatized glass slides in arrays. Single strand PCR product of PCR-amplified genomic DNA is fluorescently labeled by assymetric PCR with fluorescently tagged dUTP and hybridized to the support-bound oligonucleotide array. The hybridization pattern is detected by fluorescence scenning. The effect of hybridization conditions were evaluated and optimized. The method was validated by the discrimination of blinded DNA samples identified by restriction enzymes. 50 patients with thrombosis were examined by this method.

RESULTS

The genotypes scored by oligonucleotide arrays assay were in 100% agreement with restriction enzymes results. The genotype distributions GG, GA, AA and CC, CT, TT of RsaI and SmaI polymorphisms of patients or controls were 4.0%, 12.0%, 84.0% and 24.0%, 44.0%, 32.0% or 1.4%, 11.8%, 86.8% and 8.8%, 57.4%, 33.8%. The allele frequencies G, A and C, T were 10.0%, 90.0% and 46.0%, 54.0% or 7.4%, 92.6% and 37.5%, 62.5%. No statistical difference in genotype distribution and allele frequencies was observed between patients with thrombosis and the control groups (all P > 0.05).

CONCLUSION

A rapid and accurate method for the RsaI and SmaI polymorphisms in the von Willebrand factor gene detection, or for the analysis of single nucleotide polymorphism (SNP) has been developed using oligonucleotide arrays on glass supports. No association was observed between the Rsa I and Sma I polymorphisms in the vWF gene and thrombotic disease.

Identification and characterization of a melanin-concentrating hormone receptor

Melanin-concentrating hormone (MCH), a neuropeptide expressed in central and peripheral nervous systems, plays an important role in the control of feeding behaviors and energy metabolism. An orphan G protein-coupled receptor (SLC-1/GPR24) has recently been identified as a receptor for MCH (MCHR1). We report here the identification and characterization of a G protein-coupled receptor as the MCH receptor subtype 2 (MCHR2). MCHR2 has higher protein sequence homology to MCHR1 than any other G protein-coupled receptor. The expression of MCHR2 has been detected in many regions of the brain. In contrast to MCHR1, which is intronless in the coding region and is located at the chromosomal locus 22q13.3, the MCHR2 gene has multiple exons and is mapped to locus 6q21. MCHR2 is specifically activated by nanomolar concentrations of MCH, binds to MCH with high affinity, and signals through Gq protein. This discovery is important for a full understanding of MCH biology and the development of potential therapeutics for diseases involving MCH, including obesity.

[Application of computer image process to the research on the contact characteristics of subtalar joint]

With the use of computer image processing technology, a new method was proposed for studying the contact characteristics of the subtalar joint. The results showed the total subtalar articulation area was 9.52 +/- 0.40 cm2. On neutral position and under 600 N load, the contact area of the subtalar joint was 2.00 +/- 0.11 cm2. The contact area of the posterior articulation was significantly larger than that of the anterior and medial articulation (p < 0.01). The average contact pressure was 19.3 +/- 1.38 N, the force transmitted by the subtalar was 389.16 +/- 28.75 N, which accounted for about 64.86% of the applied shank load (600 N), and 69.39% of the force was transmitted by the posterior articulation. The posterior articulation plays an important role in the load. The fracture line of the calcaneus often appears in this area.

[The computer-aided measurement of medullary canal in proximal femur]

This study was conducted to search the law of the parameters of medullary canal section shape in proximal femur. The methods of image-processing and taper-curve-fit mathematics were adopted in the acquisition of data and parameters. Computer-aided method and manual method were employed to measure 10 samples of section shape in proximal femur. The results showed that no significant difference was seen between the computer-aided method and manual method(P> 0.05). This approach could reduce man-made errors and process mass samples automatically by computer.

Effects of recombinant human growth hormone (r-hGH) on experimental osteoporotic fracture healing

OBJECTIVE

To observe the effect of recombinant human growth hormone (r-hGH) on osteoporotic fracture healing in rats, and to provide an effective therapy for osteoporotic fracture.

METHODS

Thirty-six female 8-month-old SD rats were randomized into two groups: therapy group and control group. After the experimental model of osteoporotic fracture was established, the therapy group was treated with r-hGH of 2.7 mg/kg body weigh/day (1 mg=3 IU) for 10 days continuously by daily subcutaneous injection; whereas the control group was treated with equivalent saline. Plasma insulin-like growth factor I concentration was detected and bone mineral density (BMD) as well as biomechanical strength of callus were measured at 2, 4, 8 weeks.

RESULTS

Plasma insulin-like growth factor I concentration in the therapy group was higher than that in the control group (P<0.005) at 2nd week and began to decline at 4th week. At 8th week, there was no significant difference between the two groups. At 4th week, callus area and BMD in therapy group were higher than those in the control group, but at 8th week, they were lower and BMD had a significant difference between the two groups (P<0.001). Biomechanical testing of callus showed that torsional strength of the therapy group was higher than that of the control group at 4th or 8th week, meanwhile maximum torsional angle had a significant difference between the two groups (P<0.005).

CONCLUSIONS

The results show that exogenous r-hGH can stimulate osteoporotic fracture healing in rats.

Stress-relaxation plates and the remodeling of callus and cortex under the plate in rabbits

OBJECTIVE

To study the influence of a stress-relaxation plate on the remodeling of callus and cortex under the plate.

METHODS

The bilateral tibia diaphysis of New Zealand rabbit were osteotomized and fixed with stress-relaxation plate (SRP) and rigid plate (RP), respectively. Polarized light microscopy and transmission electron microscopy (TEM) were used to study the remodeling of callus and the cortex under the plate from 4 to 24 weeks postoperatively.

RESULTS

Polarized light microscopy: the structural changes of callus and cortex beneath the plate are similar in the SRP and RP groups at the early postoperative stage, manifesting an alignment disorder of collagen fibers with a weak birefringence in the callus and absorption cavities in the cortex under the plate. After the twelfth postoperative week, the SRP group showed callus starting to transform to lamellar bone and absorption cavities in the cortex under the plate becoming smaller. By contrast in the RP group the absorption cavities in the callus and cortex under the plate became larger and the whole layer of cortex was cancellated. TEM: the active osteoclasts appeared in both SRP and RP groups in the period from 4 to 8 weeks postoperatively. In the SRP group, many functionally active osteoblasts could be seen on the surface of the bone, while in the RP group, the osteoblasts were not very active. By 24 weeks postoperatively, the shape of osteocytes were normal but the number of the osteoclasts were small in the SRP group. In the RP group, the osteoclasts became more active and osteocytic osteolysis was manifested.

CONCLUSIONS

Fixation with SRP not only enhanced callus remodeling, but also abated the degree of osteoporosis in the cortex under the plate. This approach may lead to an improved osteosynthetic apparatus.

Three mRNA transcripts of the proopiomelanocortin gene in human placenta at term

The proopiomelanocortin (POMC) gene whose normal pituitary specific mRNA product is 1200 bases (b) is also expressed in placenta and its peptide derivatives such as ACTH and beta-endorphin may play an important role in the initiation of labor. So far, two mRNA transcripts, one small (800b) and one large (1380b) have been reported in placenta by Northern blot analysis, similar to other endocrine tissues and various extrapituitary tumors; however, it is questionable whether both of these transcripts are effectively translated to a functional protein. We examined by Northern blot analysis the size and the differential expression of placental POMC gene transcripts in pregnant women with different modes of delivery. Placental tissues were collected from two groups of pregnant women, six with vaginal delivery (VD) and five with cesarean section (CS). In both groups of placentae three POMC gene transcripts were detected of 800, 1200 and 1380 bases; the 1200b pituitary specific species often predominated and was always present. The 800b transcript was also always present, while the large transcript (1380b) was expressed in 3/6 VD and 2/5 CS placental tissues. No differences in the relative levels of any of these mRNA species showing effect of the mode of delivery were observed. We conclude that POMC gene transcription in placental tissue at term gives rise to three mRNA transcripts, thus resembling extrapituitary tumors. The reported changes in the levels of the derivative peptides according to the mode of delivery do not reflect changes in POMC mRNA levels and could be attributed to a post-translational effect.

[Effects of recombinant human growth hormone on cortical bone of ovariectomized rats]

OBJECTIVE

To study the effects of recombinant human growth hormone on cortical bone of middle femur and vertebra of variectomized rats.

METHODS

Forty 6 month-old SD rats received low or high dose of growth hormone subcutaneously 3 months after ovariectomy for 8 weeks. Bone density and biomechanical strength of the femur were measured, and the thickness of cortical bone of the middle femur and L(2) vertebra was observed. The results were compared with those in estrogen group.

RESULTS

Growth hormone increased the thickness of cortical bone and biomechanical strength and bone density. Estrogen therapy showed no effects on bone density and biomechanical strength of cortical bone.

CONCLUSION

Recombinant human growth hormone can prevent bone loss from cortical bone of ovariectomized rat.

p53-independent role of MDM2 in TGF-beta1 resistance

Transforming growth factor-beta (TGF-beta) inhibits cell proliferation, and acquisition of TGF-beta resistance has been linked to tumorigenesis. A genetic screen was performed to identify complementary DNAs that abrogated TGF-beta sensitivity in mink lung epithelial cells. Ectopic expression of murine double minute 2 rescued TGF-beta-induced growth arrest in a p53-independent manner by interference with retinoblastoma susceptibility gene product (Rb)/E2F function. In human breast tumor cells, increased MDM2 expression levels correlated with TGF-beta resistance. Thus, MDM2 may confer TGF-beta resistance in a subset of tumors and may promote tumorigenesis by interference with two independent tumor suppressors, p53 and Rb.