Diabetic Osteoporosis: A Review of Its Traditional Chinese Medicinal Use and Clinical and Preclinical Research

Aim. The incidence of diabetic osteoporosis (DOP) is increasing due to lack of effective management over the past few decades. This review aims to summarize traditional Chinese medicine (TCM) suitability in the pathogenesis and clinical and preclinical management of DOP. Methods. Literature sources used were from Medline (Pubmed), CNKI (China Knowledge Resource Integrated Database), and CSTJ (China Science and Technology Journal Database) online databases. For the consultation, keywords such as diabetic osteoporosis (DOP), TCM, clinical study, animal experiment, toxicity, and research progress were used in various combinations. Around 100 research papers and reviews were visited. Results. Liver-spleen-kidney insufficiency may result in development of DOP. 18 clinical trials are identified to use TCM compound prescriptions for management of patients with DOP. TCM herbs and their active ingredients are effective in preventing the development of DOP in streptozotocin (STZ) and alloxan as well as STZ combined with ovariectomy insulted rats. Among them, most frequently used TCM herbs in clinical trials are Radix Astragali, Radix et Rhizoma Salviae Miltiorrhizae, Radix Rehmanniae Preparata, and Herba Epimedii. Some of TCM herbs also exhibit toxicities in clinical and preclinical research. Conclusions. TCM herbs may act as the novel sources of anti-DOP drugs by improving bone and glucolipid metabolisms. However, the pathogenesis of DOP and the material base of TCM herbs still merit further study

Aqueous Extract of Mori Folium Exerts Bone Protective Effect Through Regulation of Calcium and Redox Homeostasis via PTH/VDR/CaBP and AGEs/RAGE/Nox4/NF-κB Signaling in Diabetic Rats

Purpose: The present study is aimed to explore whether the aqueous extract of Mori Folium (MF) exhibits bone protective effect by regulating calcium and redox homeostasis in diabetic rats, and to identify the signaling pathways involved in this process.Methods: Diabetic rats were established using high-sugar and high-fat diet and streptozotocin (STZ) (30 mg/kg for 3 consecutive days). The serum levels of osteocalcin (OC), insulin-like growth factor-1 (IGF-1), tartrate-resistant acid phosphatase (TRAP), phosphorus (P), calcium (Ca), 1,25-dihydroxyvitamin D3 [1,25(OH)2D3], parathormone (PTH), advanced glycation end products (AGEs), superoxide dismutase (SOD), and malondialdehyde (MDA), total antioxidant capacity (TAC), 8-hydroxy-2′-deoxyguanosine (8-OH-dG), and interleukin 6 (IL-6) were determined by ELISA or biochemical assays. Histopathological alterations in the femurs were evaluated by the stainings of hematoxylin-eosin (H&E) and alizarin red S. In addition, femoral strength was detected by a three-point bending assay, bone microstructure was detected with micro-computer tomography. Bone material properties were examined by Fourier-transform infrared spectroscopy. Furthermore, the expressions of IGF-1, runt-related transcription factor 2 (Runx2), osteoprotegerin (OPG), receptor activator of nuclear factor kappa-B ligand (RANKL), cathepsin K, AGEs, receptor of advanced glycation end products (RAGE), NADPH oxidase 4 (Nox4), and nuclear factor kappa-B (NF-κB) in the femurs and tibias, and the alterations in the levels of calcium-binding protein-28k (CaBP-28k), transient receptor potential V6 (TRPV6), and vitamin D receptor (VDR) in the kidneys and duodenums were determined by western blot and immunohistochemical analysis.Results: Treatment of diabetic rats with MF aqueous extract induces an increase in the levels of OC and IGF-1 as well as a decrease in TRAP level in serum. MF treatment also upregulates the expression of OPG, downregulates the expressions of AGEs, RAGE, Nox4, NF-κB, and RANKL, which leads to improve bone microstructure and strength exhibited by an increase in cortical area ratio, cortical thickness, and trabecular area ratio as well as ultimate load, elastic modulus, and bending stress in the femurs and tibias of diabetic rats. In addition, MF aqueous extract preserves bone material properties by decreasing the ratio of fatty acid/collagen and increasing the ratio of mineral/matrix in the femurs of diabetic rats. Moreover, MF treatment increases the levels of P, Ca, and 1,25(OH)2D3, and decreases the level of PTH in the serum, as well as upregulates the expressions of TRPV6 and VDR in the duodenums and CaBP-28k in the kidneys of diabetic rats. Additionally, MF has ability of rebuilding redox homeostasis and eliminating inflammatory stress by increasing the levels of SOD and TAC as well as decreasing the levels of IL-6, AGEs, MDA, and 8-OH-dG.Conclusions: MF treatment may improve bone quality through maintenance of calcium homeostasis via regulating the PTH/VDR/CaBP signaling, and elimination of oxidative stress via regulating the AGEs/RAGE/Nox4/NF-κB signaling. These results may suggest the potential of MF in preventing the development of diabetic osteoporosis

A Low-Cost iPhone-Assisted Augmented Reality Solution for the Localization of Intracranial Lesions.

Precise location of intracranial lesions before surgery is important, but occasionally difficult. Modern navigation systems are very helpful, but expensive. A low-cost solution that could locate brain lesions and their surface projections in augmented reality would be beneficial. We used an iPhone to partially achieve this goal, and evaluated its accuracy and feasibility in a clinical neurosurgery setting.We located brain lesions in 35 patients, and using an iPhone, we depicted the lesion's surface projection onto the skin of the head. To assess the accuracy of this method, we pasted computed tomography (CT) markers surrounding the depicted lesion boundaries on the skin onto 15 patients. CT scans were then performed with or without contrast enhancement. The deviations (D) between the CT markers and the actual lesion boundaries were measured. We found that 97.7% of the markers displayed a high accuracy level (D ≤ 5mm). In the remaining 20 patients, we compared our iPhone-based method with a frameless neuronavigation system. Four check points were chosen on the skin surrounding the depicted lesion boundaries, to assess the deviations between the two methods. The integrated offset was calculated according to the deviations at the four check points. We found that for the supratentorial lesions, the medial offset between these two methods was 2.90 mm and the maximum offset was 4.2 mm.This low-cost, image-based, iPhone-assisted, augmented reality solution is technically feasible, and helpful for the localization of some intracranial lesions, especially shallow supratentorial intracranial lesions of moderate size

Limitations of GC-QTOF-MS Technique in Identification of Odorous Compounds from Wastewater: The Application of GC-IMS as Supplement for Odor Profiling

Odorous emissions from wastewater treatment plants (WWTPs) cause negative impacts on the surrounding areas and possible health risks on nearby residents. However, the efficient and reliable identification of WWTPs’ odorants is still challenging. In this study, odorous volatile organic compounds (VOCs) from domestic wastewater at different processing units were profiled and identified using gas chromatography-ion mobility spectrometry (GC-IMS) and gas chromatography quadrupole-time-of-flight mass spectrometry (GC-QTOF-MS). The GC-QTOF-MS results confirmed the odor contribution of sulfur organic compounds in wastewater before primary sedimentation and ruled out the significance of most of the hydrocarbons in wastewater odor. The problems in odorous compounds analysis using GC-QTOF-MS were discussed. GC-IMS was developed for visualized analysis on composition characteristics of odorants. Varied volatile compounds were detected by GC-IMS, mainly oxygen-containing VOCs including alcohols, fatty acids, aldehydes and ketones with low odor threshold values. The fingerprint plot of IMS spectra showed the variation in VOCs’ composition, indicating the changes of wastewater quality during treatment process. The GC-IMS technique may provide an efficient profiling method for the changes of inlet water and performance of treatment process at WWTPs

Preprocessing of the MR images.

<p>(A) A sagittal slice showing the maximal tumor boundary is selected as the first image. (B) A mid-sagittal slice is selected as the second image. (C) In MS Paint, the “Free-Form Select” tool (red arrow) and “Transparent Select” tool (black) are chosen. The tumor and the “P” label (white arrow) are selected together. (D) The selected tumor and the “P” label are cut out together. (E) The selected tumor and “P” label (white arrow) are pasted into the mid-sagittal slice. The red arrow indicates the corresponding “P” label in the mid-sagittal slice. (F) By making the two “P” labels overlap (half white and half red arrow), the projection of the tumor on the mid-sagittal slice is correctly depicted.</p

Acquisition of the sagittal photograph of the patient.

<p>(A) When the iPhone is tilted front-to-back, the white round dot deviates from the center of the circle in the LVL CAM iOS app (Daniel LLC, App Store; Apple Inc.). When the iPhone is tilted left-to-right, the short bar by the side of the round circle deviates from the horizontal line. (B) When the iPhone is vertical to the ground, the round spot and short bars turn to green, and the deviations are zero. (C) Aiming of the round marker at the external ear, and positioning of the patient’s head in the center square on the screen for acquisition of the photograph. (D) Illustration demonstrating the relative position between the iPhone and the patient’s head. In the frontal view, the patient’s head and the iPhone are both vertical to the ground. The distance and height are kept stable. In the view of the top of the head, fine changes to the shooting angle to find the best sagittal plane are demonstrated.</p

MEDAG expression in vitro and paeoniflorin alleviates bone loss by regulating the MEDAG/AMPK/PPARγ signaling pathway in vivo

Objectives: Osteoporosis (OP) is characterized by reduced bone mass and impaired bone microstructure. Paeoniflorin (PF) is isolated from peony root with anti-inflammatory, immunomodulatory, and bone-protective effects. Up to now, the mechanism of anti-OP in PF has not been completely clarified. Methods: The expression of MEDAG in osteoclasts, osteoblasts and adipocytes was detected by RT-qPCR. The OVX mouse model was constructed, and oral administration of PF was performed for 15 weeks. Bone microstructure was detected by H&E staining and a micro-CT system, and expression of signaling proteins examined by Western blot and immunohistochemical staining. ELISA and biochemical kits were used to quantify serum metabolite levels. Key findings: MEDAG were upregulated in osteoclasts and adipocytes, and downregulated in osteoblasts. PF administration effectively alleviated OVX-induced bone loss, and histological changes in femur tissues. Moreover, PF significantly reduced serum TRAP, CTX-1, P1NP, BALP, and LDL-C levels and increased HDL-C. In addition, PF inhibited the expression of MEDAG, cathepsin K, NFATc1, PPARγ, and C/EBPα and increased p-AMPKα, OPG and Runx2. Conclusions: MEDAG is a potential target for bone diseases, and PF might attenuate OVX-induced osteoporosis via MEDAG/AMPK/PPARγ signaling pathway

Patient characteristics of the second stage.

<p>Patient characteristics of the second stage.</p

Markers’ deviation and accuracy level.

<p>Markers’ deviation and accuracy level.</p

Comparison of markers’ deviation of different operators.

<p>Comparison of markers’ deviation of different operators.</p