Objective:This review aimed to provide a current recommendation to multidisciplinary physicians for early detection, diagnosis, and treatment of corticosteroid-induced osteonecrosis of the femoral head (ONFH) based on a comprehensive analysis of the clinical literature.Data Sources:For the purpose of collecting potentially eligible articles, we searched for articles in the PubMed, Cochrane Library, Embase, and CNKI databases up to February 2017, using the following key words: “corticosteroid”, “osteonecrosis of the femoral head”, “risk factors”, “diagnosis”, “prognosis”, and “treatment”.Study Selection:Articles on relationships between corticosteroid and ONFH were selected for this review. Articles on the diagnosis, prognosis, and intervention of earlier-stage ONFH were also reviewed.Results:The incidence of corticosteroid-induced ONFH was associated with high doses of corticosteroids, and underlying diseases in certain predisposed individuals mainly occurred in the first 3 months of corticosteroid prescription. The enhanced awareness and minimized exposure to the established risk factors and earlier definitive diagnosis are essential for the success of joint preservation. When following up patients with ONFH, treatment should be started if necessary. Surgical treatment yielded better results than conservative therapy in earlier-stage ONFH. The ideal purpose of earlier intervention and treatment is permanent preservation of the femoral head without physical restrictions in daily living.Conclusions:Clinicians should enhance their precaution awareness of corticosteroid-induced ONFH. For high-risk patients, regular follow-up is very important in the 1st year after high-dose prescription of corticosteroids. Patients with suspected ONFH should be referred to orthopedists for diagnosis and treatment in its earlier stage to preserve the joint.

Fibronectin (FN) and hyaluronan (HA) in bronchoalveolar lavage fluid (BALF) and FN released by alveolar macrophages (AM) were examined in 7 nonsmoking healthy control subjects, and 20 smoking patients with chronic obstructive pulmonary diseases (COPD). All patients and subjects were no more than 40 years old. According to the 95 % confidence limits of HA and FN in BALF from nonsmoking healthy control subjects, the smoking patients were divided into two groups, those who had HA and FN levels within the limits for nonsmoking controls were classified as the first group (group 1) and those with levels above the control limits were classified as the second group (group 2). Our data showed that the concentrations of HA and FN in BALF and FN released by AM were significantly higher in group 2 than in group 1 patients. There were also significant differences between the two groups in pulmonary function measurements (DL_CO, FEV₁, and FEV₁/FVC) which were lower in group 2. HA levels in group 2 patients correlated directly with counts of inflammatory cells in BALF (BALF cells/ml, and numbers/ml of total cells, macrophages, neutrophils and lymphocytes), and the concentration of FN released by AM, and showed an inverse correlation with pulmonary function (DL_CO and FEV₁/FVC). Our results suggest that the inflammatory repair response and fibrosis may play a role in the development of emphysema in young patients with COPD.

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The effect of poly(L-lactide-co-glycolide)/bioactive glass (PLGA/BG) on cell attachment, proliferation and differentiation of L929 fibroblastic cells was investigated. The results ofin-vitrocytotoxicity test indicated that the cells cultured in extract of PLGA/BG and on the surface of composite showed normal growth and proliferation. The cell proliferation and alkaline phosphatase (ALP) activity of fibroblast were significantly improved after 3 and 7 days of culture on PLGA/BG films in comparison with PLGA films. It can be concluded that the addition of bioactive glass into PLGA stimulates the proliferation and differentiation of fibroblastic cells. Therefore, PLGA/BG composites have a promising biological response as a potential biomaterial in medical field.