Active Achilles tendon kinesitherapy accelerates Achilles tendon repair by promoting neurite regeneration

Active Achilles tendon kinesitherapy facilitates the functional recovery of a ruptured Achilles tendon. However, protein expression during the healing process remains a controversial issue. New Zealand rabbits, aged 14 weeks, underwent tenotomy followed immediately by Achilles tendon microsurgery to repair the Achilles tendon rupture. The tendon was then immobilized or subjected to postoperative early motion treatment (kinesitherapy). Mass spectrography results showed that after 14 days of motion treatment, 18 protein spots were differentially expressed, among which, 12 were up-regulated, consisting of gelsolin isoform b and neurite growth-related protein collapsing response mediator protein 2. Western blot analysis showed that gelsolin isoform b was up-regulated at days 7-21 of motion treatment. These findings suggest that active Achilles tendon kinesitherapy promotes the neurite regeneration of a ruptured Achilles tendon and gelsolin isoform b can be used as a biomarker for Achilles tendon healing after kinesitherapy.     

Kazakh Therapy on Differential Protein Expression of Achilles Tendon Healing in a 7-Day Postoperative Rabbit Model

Objective: To compare the effect of cast immobilization with that of early Kiymil arkili emdew (Kazakh exercise therapy) on the post-operative healing of Achilles tendon rupture in rabbits, and to observe the influence of early Kiymil arkili emdew on the differentially expressed proteins in the healing tendon. Methods: Forty-five New Zealand white rabbits were randomly divided into three groups (Arm A: control group; Arm B: postoperative immobilization group; and Arm C: postoperative early Kiymil arkili emdew group). After tenotomy, the rabbits of the two experimental groups received microsurgery to repair the ruptured tendons, and then received either cast immobilization or early Kiymil arkili emdew treatment. Achilles tendon tissue samples were collected 7 days after the surgery, and two-dimensional gel electrophoresis and MALDI-TOF-MS technique were used to analyze differentially expressed proteins in the tendon tissue of the three Arms. Results: A total of 462.67±11.59, 532.33±27.79, and 515.33±6.56 protein spots were detected by the two-dimensional polyacrylamide gels in the Achilles tendon samples of the rabbits in Arms A, B, and C, respectively. Nineteen differentially expressed protein spots were randomly selected from Arm C. Among them, 7 were unique, and 15 had five times higher abundance than those in Arm B. These included annexin A2, gelsolin isoforms and α-1 Type III collagen. It was confirmed by western blot that gelsolin isoform b, annexin A2, etc. had specific and incremental expression in Arm C. Conclusions: The self-protective instincts of humans were overlooked in the classical postoperative treatment for Achilles tendon rupture with cast immobilization. Kiymil arkili emdew induced the specific and incremental expression of proteins in the repaired Achilles tendon in the early healing stage in a rabbit model, compared with those treated with postoperative cast immobilization. These differentially expressed proteins may contribute to the healing of the Achilles tendon via a mechanobiological mechanism caused by the application of Kiymil arkili emdew.     

类风湿关节炎单独甲氨蝶呤与三联疗法治疗的系统评价

背景：目前类风湿关节炎在治疗上选择甲氨蝶呤单独疗法还是三联疗法存在争议。目的：系统评价甲氨蝶呤单独疗法与甲氨喋呤+羟氯喹+柳氮磺吡啶三联疗法比较治疗类风湿关节炎的有效性和安全性。方法：计算机检索 Cochrane 图书馆、PubMed、EMBASE NRR (http://www.updatesoftware.com/National)、CCT(http://www.controlled-trails.com)和中国生物医学文献数据库(CBM)。手工检索(中文主要骨科杂志)。收集甲氨蝶呤单独疗法与甲氨喋呤+羟氯喹+柳氮磺吡啶三联疗法比较治疗类风湿关节炎的随机对照试验, 并评价纳入研究的方法学质量。统计采用Cochrane协作网提供的Revman 5.0软件进行分析。结果与结论：共纳入随机对照试验4篇,共297例患者,方法学质量均为B 级。Meta分析结果表明, 甲氨蝶呤单独疗法与三联疗法比较,甲氨蝶呤单独疗法在血沉方面的改善要大于三联疗法[MD=7.01 95%CI(2.82,11.19),P=0.001],三联疗法在关节改善情况方面优于单独疗法[OR=0.62 95%(0.41,0.95),P=0.03],在不良反应上,两者差异无显著性意义。而ACR因文献未提供详细数据未能做Meta分析。与三联疗法治疗相比,甲氨蝶呤单独疗法更明显降低成人类风湿关节炎的血沉,但在关节功能改善方面三联疗法要优于甲氨蝶呤单独疗法。而在不良反应上,两组差异无显著性意义。因这次系统评价纳入的病例数较少,尚需更多设计严格的大样本随机对照研究来增加证据的强度。中国组织工程研究杂志出版内容重点：人工关节;骨植入物;脊柱;骨折;内固定;数字化骨科;组织工程全文链接：     

Kazakh therapy on differential protein expression of Achilles tendon healing in a 7-day postoperative rabbit model

Objective: To compare the effect of cast immobilization with that of early Kiymil arkili emdew (Kazakh exercise therapy) on the post-operative healing of Achilles tendon rupture in rabbits,and to observe the influence of early Kiymil arkili emdew on the differentially expressed proteins in the healing tendon.Methods: Forty-five New Zealand white rabbits were randomly divided into three groups (Arm A: control group;Arm B: postoperative immobilization group; and Arm C: postoperative early Kiymil arkili emdew group).After tenotomy,the rabbits of the two experimental groups received microsurgery to repair the ruptured tendons,and then received either cast immobilization or early Kiymil arkili emdew treatment.Achilles tendon tissue samples were collected 7 days after the surgery,and two-dimensional gel electrophoresis and MALDI-TOF-MS technique were used to analyze differentially expressed proteins in the tendon tissue of the three Arms.Results: A total of 462.67+11.59,532.33+27.79,and 515.33+6.56 protein spots were detected by the two-dimensional polyacrylamide gels in the Achilles tendon samples of the rabbits in Arms A,B,and C,respectively.Nineteen differentially expressed protein spots were randomly selected from Arm C.Among them,7 were unique,and 15 had five times higher abundance than those in Arm B.These included annexin A2,gelsolin isoforms and α-1 Type Ⅲ collagen.It was confirmed by western blot that gelsolin isoform b,annexin A2,etc.had specific and incremental expression in Arm C.Conclusions: The self-protective instincts of humans were overlooked in the classical postoperative treatment for Achilles tendon rupture with cast immobilization.Kiymil arkili emdew induced the specific and incremental expression of proteins in the repaired Achilles tendon in the early healing stage in a rabbit model,compared with those treated with postoperative cast immobilization.These differentially expressed proteins may contribute to the healing of the Achilles tendon via a mechanobiological mechanism caused by the application of Kiymil arkili emdew.