Congenital scoliosis (CS) patients frequently exhibit low bone mineral density. This study aimed to investigate whether Astragaloside (AST) enhances the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) derived from CS patients. In vitro experiments demonstrated that AST, at an optimal concentration of 8 & micro;g/mL, significantly promotes BMSC proliferation, enhances osteogenic activity, and upregulates the expression of osteogenic markers, including RUNX2, OPN, and WISP2/3-catenin. The pro-osteogenic effect of AST was found to be inhibited by the Wnt inhibitor DKK1. Additionally, molecular docking studies confirmed that AST binds to WISP2. In conclusion, AST facilitates osteogenesis in CS-derived BMSCs by upregulating WISP2, which activates the Wnt/3-catenin signaling pathway.

Bone defects caused by various factors have become a persistent challenge in orthopedic clinics, and traditional treatment methods mainly comprise artificial bone or autologous bone transplantation. However, these methods have considerable limitations, such as bone depletion, immune rejection, and the risk of secondary infection at the donor site. Therefore, considering these limitations and the rapid development of the field of bone tissue engineering, this study adopted light-curing stereolithography three-dimensional (3D)-printing technology to design bone scaffold materials. The technology was used to prepare hydroxyapatite (HA)/zirconium dioxide (ZrO2) porous composites with satisfactory mechanical properties as tissue engineering bone scaffold materials. A BMP-2 loaded gelatin/chitosan hydrogel sustained-release system was prepared via an emulsification and cross-linking process. Subsequently, rhesus macaque bone marrow mesenchymal stem cells (BMSCs) were seeded into the system acting as osteogenic progenitors. Novel HA/ZrO2 scaffolds were fabricated using stereolithography (SLA) 3D printing technology to serve as bone graft substitutes. The resulting scaffold exhibited a 3D interconnected porous structure and showed good biocompatibility and osteoinductive ability in a rhesus macaque lumbar vertebral bone defect model. The results confirmed that the scaffold achieved osteogenic efficiency comparable to that of autologous bone grafting in rhesus macaques. Therefore, the developed scaffold material has promising potential in bone defect repair.

Postmenopausal osteoporosis (PMOP) is a chronic systemic bone metabolism disorder. Promotion in the patterns of human bone marrow mesenchymal stem cells (hBMSCs) differentiation towards osteoblasts contributes to alleviating osteoporosis. Aucubin, a natural compound isolated from the well-known herbal medicine Eucommia, was previously shown to possess various pharmacological effects. However, its effects on hBMSCs of PMOP patients are unknown. The aim of this present research was to investigate the impact and underlying process of aucubin on cell proliferation and osteogenic differentiation in hBMSCs isolated from PMOP patients. The ability of aucubin to inhibit the ferroptosis induced by erastin in hBMSCs was detected; ROS production, ferrous ion levels, SOD, MDA, and GPX activities were tested by using commercial kits. Next, ALP staining, ARS staining, RT-qPCR, RNA-sequencing, and Western blot were applied for determining the mRNA and protein expression levels associated with the osteogenesis of hBMSCs. The study also explored the involvement of BMP2/Smads signalling in aucubin promoting the osteogenesis of hBMSCs and evaluated the effects of aucubin intervention on osteoporosis using an ovariectomised rat model. The results indicated that aucubin significantly inhibited ROS generation and oxidative stress induced by erastin and protected against ferroptosis in hBMSCs. Additionally, aucubin facilitated osteogenic differentiation of hBMSCs by activating the BMP2/SMADs pathway and attenuated the progression of osteoporosis in OVX rats, suggesting a potential therapeutic benefit for postmenopausal osteoporosis (PMOP).

Osteoporosis is characterized by an imbalance between osteoblasts and osteoclasts coupling and excessive oxidative stress in the bone microenvironment that impairs bone defect healing and increases the risk of non‐union. In this study, an injectable gypsogenin (GN)‐based organic–inorganic composite hydrogel (CCT/nHA@GN) is developed to treat osteoporotic bone defects. The hydrogel is made by grafting sodium citrate (SC) and nano‐hydroxyapatite (nHA)/GN nanoparticles onto carboxymethylated chitosan (CMCS). GN is a natural small‐molecule saponin, which shows biocompatibility and anti‐oxidant properties. The resulting hydrogel shows a well‐defined porous structure, favorable degradability, controlled drug‐release properties, and suitable rheological characteristics. Importantly, it reverses the differentiation fate of bone marrow‐derived mesenchymal stem cells (BMSCs) from osteoporotic patients and promotes angiogenesis in human umbilical vein endothelial cells (HUVECs). Furthermore, it activates the AMPKα‐FOXO3a‐CAT/MnSOD signaling pathway via AMPKα phosphorylation, thereby augmenting antioxidant stress capacity, promoting osteogenesis, inhibiting osteoclastogenesis, and ultimately rectifying the disrupted bone microenvironment. In vivo studies reveal that the bone volume to total volume (BV/TV) ratio of bones regenerated with the CCT/nHA@GN hydrogel is 2.85 times higher than that of the control group. In conclusion, these findings suggest that the injectable CCT/nHA@GN hydrogel can be a promising alternative material for the treatment of osteoporotic bone defects.

Osteoporosis is a systemic disease with high morbidity and significant adverse effects. Increasing evidence supports the close relationship between oxidative stress and osteoporosis, suggesting that treatment with antioxidants may be a viable approach. This study evaluated the antioxidant properties of dichotomitin (DH) and its potential protective effects against osteoporosis. SD rats were divided into three groups: Sham, OVX, and OVX + DH (5 mg/kg, intraperitoneal injection twice weekly). After three months, blood samples, femurs, and tibiae were collected for analysis. Micro-CT evaluated the femoral, while histological examination assessed tibial tissues. Serum osteogenic biochemical markers were measured. In vitro, osteogenic differentiation was induced with varying concentrations of DH, followed by ALP and ARS staining. RT-qPCR and western blot were used to assess the expression of osteogenesis-related genes and proteins. Additionally, an oxidative stress cell model was established, dividing cells into control, H2O2-treated, and H2O2 + DH-treated groups. Expression of oxidative stress-related genes and proteins was assessed using real-time quantitative PCR and western blotting. Micro-CT and histological staining revealed decreased and disrupted bone trabeculae in the OVX group, whereas the DH-treated group exhibited enhanced bone trabecular area and structure compared to the OVX group. In vitro studies showed that DH enhanced ALP activity and elevated expression of RUNX2, OPN, OCN, SOD1, and SOD2. DH has the potential to enhance osteoblast differentiation and alleviate osteoporosis through the attenuation of oxidative stress.

OBJECTIVE:To compare the efficacy of percutaneous pedicle screw combined with unilateral nail placement combined with bone cement strengthening and bilateral nail placement in the treatment of osteoporotic thoracic and lumbar fractures. METHODS:A retrospective case-control study was used to analyze the clinical data of 78 patients with osteoporotic thoracic and lumbar fractures admitted from October 2017 to May 2019. According to the surgical method, it was divided into percutaneous pedicle screw combined with unilateral nail placement combined with unilateral bone cement strengthening group(bone cement group) and percutaneous pedicle screw combined with bilateral nail placement(screw group). In the bone cement group, 40 patients included 16 males and 24 females, with a mean age of (62.1±8.1) years old. In the screw group, 38 patients included 18 males and 20 females with a mean age of (65.1±9.3) years old. The operation time, intraoperative blood loss, length of hospital stay and postoperative complications were compared between two groups. The kyphosis Cobb angle, anterior edge height ratio, central height ratio and pain visual analogue score(VAS) were compared. RESULTS:All patients were followed up for 25 to 36 months. The operation time (70.1±17.3) min of the cement group was shorter than that of the screw group (78.6±18.2) min(P<0.05). There were no significant differences in intraoperative blood loss and length of hospital stay(P>0.05). The VAS in the cement group 1 year 1.5±0.5 and the latest follow-up 0.5±0.3 after operation were lower than 1 year 1.8±0.3 and the latest follow-up 0.8±0.4 in the screw group(P<0.05). The kyphosis Cobb angle, anterior edge height ratio, central height ratio in bone cement group, 1 year (6.2±1.2)°, (86.6±3.5)%, (91.1±2.5)%, the last follow-up (6.4±0.7)°, (85.5±3.3)%, (90.5±6.3)% were better than that of the screw group 1 year (6.8±1.4)°, (83.1±2.4)%, (89.9±3.4)% and the latest follow-up (7.1±1.1)°, (82.6±4.1)%, (87.6±5.9)%(P<0.05). There were 3 cases of bone cement leakage in the cement group, all of which had no clinical symptoms;and 2 cases of pedicle screws were extracted in the screw group, and the screws were removed at the last follow-up. CONCLUSION:Percutaneous pedicle screw combined with unilateral nail placement combined with bone cement strengthening and bilateral nail placement in the treatment of osteoporotic thoracic and lumbar compression fractures in the elderly can achieve satisfactory efficacy and effectively relieve the pain of patients, but the former internal fixation system is more stable, and the long-term follow-up can effectively maintain the height of the anterior middle column and the correction of kyphosis deformity, and the incidence of chronic low back pain is lower.

OBJECTIVE:To explore the efficacy and safety of human epidermal growth factor gel in the treatment of pin tract infections after surgery in patients with severe spinal deformity. METHODS:A retrospective case-control study was conducted to analyze the clinical data of 26 patients with pin tract infections after skull-pelvic ring traction for severe spinal deformity admitted from February 2019 to May 2022. Among them, 11 were male and 15 were female;the age ranged from 18 to 31 years, with an average of (24.1±4.3) years;the Cobb angle ranged 80.3° to 120.7°, with an average of (88.6±10.2)°;there were 52 iliac traction pins, 104 pin tract openings, and 38 pin tract infections. According to the Checketts-Otterbum classification, there were 11 infections of gradeⅠ, 13 infections of gradeⅡ, 10 infections of grade Ⅲ, and 4 infections of grade Ⅳ. The patients were divided into the conventional dressing change group (13 cases) and the growth factor group (13 cases) by coin flipping. Clinical efficacy was evaluated by recording the visual analogue scale(VAS) score during dressing change, duration of dressing change, cost of dressing change, positive rate of bacterial culture, wound improvement rate, and wound improvement time. RESULTS:There were no statistically significant differences in VAS or duration of dressing change between the two groups (P>0.05). The cost of dressing change was (800.0±59.5) yuan in the conventional dressing change group and (1 179.5±80.9) yuan in the growth factor group, with a statistically significant difference (P<0.05). There was no statistically significant difference in the positive rate of bacterial culture between the two groups (P>0.05). In the conventional dressing change group, within 20 pin tract infections, 2 infections achieved wound healing, 7 infections showed improvement, and 11 infections were ineffective;in the growth factor group, within 18 pin tract infections 5 infections achieved wound healing, 8 infections showed improvement, and 5 infections were ineffective, with a statistically significant difference between the two groups (P<0.05). The wound healing time was (22.8±4.9) days in the conventional dressing change group and (14.2±2.5) days in the growth factor group, with a statistically significant difference (P<0.05). No complications occurred in either group. CONCLUSION:The application of human epidermal growth factor gel in the treatment of pin tract infections after skull-pelvic ring surgery in patients with severe spinal deformity is easy to operate, does not increase patient pain, and has significant efficacy. It shortens wound healing time, effectively promotes wound healing, and has good safety and high cost-effectiveness.

BACKGROUND:N6-methyladenosine (m6A) has been identified as the most abundant modification of RNA molecules and the aberrant m6A modifications have been associated with the development of autoimmune diseases. However, the role of m6A modification in ankylosing spondylitis (AS) has not been adequately investigated. Therefore, we aimed to explore the significance of m6A regulator-mediated RNA methylation in AS. METHODS:The methylated RNA immunoprecipitation sequencing (meRIP-seq) and digital RNA sequencing (Digital RNA-seq) were conducted using the peripheral blood mononuclear cells from three AS cases and three healthy controls, to identify genes affected by abnormal RNA methylation. The genes associated with different peaks were cross-referenced with AS-related genes obtained from the GeneCards Suite. Subsequently, the expression levels of shared differentially expressed genes (DEGs) and key m6A regulators in AS were evaluated using data from 68 AS cases and 36 healthy controls from two data sets (GSE25101 and GSE73754). In addition, the results were validated through quantitative polymerase chain reaction (qPCR). RESULTS:The meRIP-seq and Digital RNA-seq analyses identified 28 genes with upregulated m6A peaks but with downregulated expression, and 52 genes with downregulated m6A peaks but with upregulated expression. By intersecting the genes associated with different peaks with 2184 AS-related genes from the GeneCards Suite, we identified a total of five shared DEGs: BCL11B, KAT6B, IL1R1, TRIB1, and ALDH2. Through analysis of the data sets and qPCR, we found that BCL11B and IL1R1 were differentially expressed in AS. Moreover, two key m6A regulators, WTAP and heterogeneous nuclear ribonucleoprotein C, were identified. CONCLUSIONS:In conclusion, the current study revealed that m6A modification plays a crucial role in AS and might hence provide a new treatment strategy for AS disease.

Objective To observe the early clinical efficacy of the zero-remember cervical Solis fusion device in the treat-ment of adjacent segment degeneration(ASD)revision after anterior cervical discectomy and fusion(ACDF).Methods A ret-rospective analysis was performed for 13 patients with adjacent spondylosis after anterior cervical discectomy bone graft fusion with Solis fusion device,including 5 males and 8 females,aging from 56 to 78 years old.The patients had intractable neck pain or superficial paresthesia of upper extremities before operation,and the effect of conservative treatment was not good.The oper-ation time,intraoperative blood loss and postoperative complications were recorded.Before operation,1 week postoperative and final follow-up,the visual analogue scale(VAS)and Japanese Orthopaedic Association(JOA)scores were used to assess clini-cal efficacy.X-ray and CT of the cervical spine were performed to measure and evaluate the height of the intervertebral space and intervertebral fusion.Results All patients were followed up from 18 to 36 months.All 13 patients successfully completed revision surgery with single gaps.The operation time was 63 to 93 min,the intraoperative blood loss was 15 to 83 ml.The pain VAS was reduced from 4 to 7 points before surgery to 1 to 3 points at 1 week and 1 to 2 points at the final follow-up.The height of the intervertebral space was increased from 5.2 to 7.2 mm before surgery to 6.4 to 8.0 mm at 1 week after surgery and 6.4 to 7.9 mm at the final follow-up.The JOA score was increased from 11 to 17 points before surgery to 13 to 17 points at 1 week af-ter surgery and 16 to 17 points at the final follow-up visit.At the final follow-up,AP and lateral X-ray films of cervical spine showed homogeneous bone fusion of the Solis fusion.One patient developed transient left upper limb weakness after surgery,which recovered at follow-up,and all patients had no dysphagia,incision hematoma or infection,and displacement.Conclusion The early clinical efficacy of Solis fusion device in the treatment of orthospondylosis after anterior cervical intervertebral fusion is satisfactory,and it has the advantages of less surgical trauma,adequate decompression,high osseointegration rate and fewer complications,which can provide a new option for minimally invasive treatment of orthospondylosis after cervical spine surgery.

Astragalus polysaccharide-containing 3D-printed scaffold shows great potential in traumatic skin repair. This study aimed to investigate its repairing effect and to combine it with proteomic technology to deeply resolve the related protein expression changes. Thirty SD rats were divided randomly into three groups ( n  = 10 per group): the sham-operated group, the model group and the scaffold group. Subsequently, we conducted a comparative analysis on trauma blood perfusion, trauma healing rate, histological changes, the expression of the YAP/TAZ signalling pathway and angiogenesis-related factors. Additionally, neonatal skin tissues were collected for proteomic analysis. The blood perfusion volume and wound healing recovery in the scaffold group were better than that in the model group ( p  < 0.05). The protein expression of STAT3, YAP, TAZ and expression of vascular-related factor A (VEGFA) in the scaffold group was higher than that in the model group ( p  < 0.05). Proteomic analysis showed that there were 207 differential proteins common to the three groups. Mitochondrial function, immune response, redox response, extracellular gap and ATP metabolic process were the main groups of differential protein changes. Oxidative phosphorylation, metabolic pathway, carbon metabolism, calcium signalling pathway, etc. were the main differential metabolic pathway change groups. Astragalus polysaccharide-containing 3D-printed scaffold had certain reversals of protein disorder. The Astragalus polysaccharide-containing 3D-printed scaffold may promote the VEGFs by activating the YAP/TAZ signalling pathway with the help of STAT3 into the nucleus, accelerating early angiogenesis of the trauma, correcting the protein disorder of the trauma and ultimately realizing the repair of the wound.

Morroniside (MOR) has shown great potential in treating atrazine (ATZ)-induced skin damage. This study aims to elucidate MOR's mechanism of action in mitigating lipid metabolism disorders and inhibiting ferroptosis to repair ATZ-induced skin damage. Twenty C57BL/6 mice were divided into four groups: the control group, the ATZ group, the MOR-H group and the MOR-L group, each comprising five mice. Following a one-month intervention, mouse skin tissues were harvested for untargeted lipid metabolomics analysis. Subsequently, the samples were assessed for indices related to ferroptosis. Untargeted lipid metabolomics analysis showed 127 differential metabolites in the ATZ vs. Ctrl group. There were 57 differential metabolites in the MOR-L vs. ATZ group. 34 differential metabolites in the MOR-H vs. ATZ group. the most obvious lipid reversal occurred after MOR-L administration, which primarily involved phospholipids, ceramides, and sphingomyelins. The levels of GPX4, Ferritin, MDA, SOD and GSH-PX, ferroptosis-related indicators, and the levels of p21 and p53, apoptosis-related indicators, were most significantly regressed in the MOR-L group (all P < 0.05). MOR may delay cellular aging and correct skin damage by reversing ATZ-induced lipid metabolism disorders, inhibiting ferroptosis and excessive oxidative stress occurrence.

Objective: To explore the surgical methods and clinical outcomes of severe angular kyphosis with the length of the spinal cord constant in the osteotomy area. Methods: Clinical data from 20 patients with severe angular kyphosis who underwent surgical treatment from January 2017 to December 2020 in the Department of Spinal Surgery,Hangzhou Xiaoshan District Hospital of Traditional Chinese Medicine were retrospectively analyzed. There were 11 males and 9 females, aged (28.5±8.9) years (range:17 to 46 years).There were 15 cases with congenital angular kyphosis,5 cases with tuberculous angular kyphosis.The angle of kyphosis was (107.1±12.9)° (range:93.2° to 131.4°).Frankel classification:2 cases with grade B,4 cases with grade C,3 cases with grade D.The kyphotic vertex was located at the T9 to T12 segments.Pedicle screws were placed in 3 or 4 adjacent segments at the proximal and distal kyphosis apex of the patients using a surgical navigation system.Piezosurgery combined with a grinding drill was used to complete the osteotomy in the apical vertebral region.Titanium mesh or artificial vertebral body was implanted,and the osteotomy surface was closed using this as the fulcrum to complete osteotomy.Spinal X-ray examination was performed before surgery,immediately after surgery and at the last follow-up,and sagittal and coronal Cobb angle,sagittal and coronary balance parameters,anterior vertebral height,posterior vertebral height,and spinal cord length were measured.Pulmonary function,visual analogue scale (VAS),and Oswestry's disability index (ODI) were collected and estimated before and after treatment.The analysis of variance of repeated measurement data was used for each evaluation index before and after treatment,and the t test was used for pairwise comparison. Results: All patients successfully completed surgery,with artificial vertebral body in 11 cases and double titanium mesh in 9 cases.The follow-up time was (28.2±2.3) months (range:26 to 31 months).Sagittal vertical axis improved from (46.9±13.7)mm(range:21.7 to 75.7 mm) before surgery to (10.7±5.5)mm (range:3.6 to 28.1 mm) after surgery,and (11.0±5.7)mm(range:3.6 to 29.3 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all P<0.01).The mean kyphotic Cobb angle was corrected from (107.1±12.9) ° (range:93.2 ° to 131.4°) before surgery to (30.6±8.5) ° (range:20.0 ° to 47.8 °) after surgery (all P<0.01),and (32.1±8.7) ° (range:18.2 ° to 50.8°) at the last follow-up,the differences were statistically significant compared to before surgery(all P<0.01).The anterior vertebral height improved from (14.2±2.9)mm(range:11.04 to 23.6 mm) before surgery to (45.3±7.5)mm(range:29.4 to 56.5 mm) after surgery,and (44.3±6.8)mm(range:29.6 to 56.0 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all P<0.01).The posterior vertebral height was improved from (51.8±5.3)mm (range:43.1 to 61.4 mm)before surgery to (57.6±4.7)mm (range:45.7 to 64.1 mm)after surgery,and (56.3±5.0) mm (range:49.7 to 68.5 mm) at the last follow-up,the differences were statistically significant compared to before surgery (all P<0.01).The spinal cord length of the osteotomy segment was (73.1±12.0)mm (range:56.8 to 98.4 mm) before surgery and (74.8±12.8)mm (range:53.5 to 100.2 mm) after surgery and (75.2±13.7)mm (range:53.9 to 102.4 mm) at the last follow-up,the difference was not statistically significant among them(F=0.144,P=0.866).The ODI and VAS scores improved significantly after surgery and at the last follow-up,and the differences were statistically significant (all P<0.01). Conclusion: The posterior vertebral column resection technique combined with titanium mesh or an artificial vertebral body implant for the treatment of severe angular kyphosis can significantly improve the kyphosis,neurological function,and life quality of patients without affecting the length of the spinal cord.

To study the outcomes of bi-vertebral transpedicular wedge osteotomy in correcting severe kyphotic deformity in ankylosing spondylitis (AS). This retrospective study focused on all the patients who underwent thoracic and lumbar bi-vertebra transpedicular wedge osteotomy with pedicle screw internal fixation to treat their severe thoracolumbar kyphotic deformity of AS in our hospital from January 2014 to January 2020. The perioperative and operative data of each patient were collected and analyzed. A total of 21 male AS patients with severe kyphotic deformity were studied with a mean age of 42.2 & PLUSMN; 9.2 years. Intraoperatively, the mean operating time is 5.8 & PLUSMN; 1.6 hour with a mean blood loss of 725.5 & PLUSMN; 140.6 mL. The average postoperative correction of kyphosis reached 60.8(o) at 1 week after the surgery, which is significantly improved from preoperative presentation (P < .05), and stayed no significant change over the time during longer period of follow-ups (12-24 months) with the overall correction rate of 72.2%. Moreover, the postoperative changes in thoracic kyphosis (TK) angle, thoracolumbar kyphosis (TLK) angle, lumbar lordosis (LL) angle, maxilla-brow angle, as well as C2SVA and C7SVA sagittal balance were also significant, all of which enabled the patients to walk in upright position and sleep in the supine position with the improvements in other clinical symptoms. Bi-vertebral transpedicular wedge osteotomy of thoracic and lumbar vertebrae is a safe and effective method to restore the physiological curvature of the sagittal position of the spine and correct severe ankylosing deformity.

The preparation of biodegradable scaffolds loaded with cells and cytokine is a feature of tissue-engineered skin. IPSCs-based tissue-engineered skin treatment for wound repair is worth exploring. Healthy human skin fibroblasts were collected and reprogrammed into iPSCs. After gene modification and induction, CK19+ /Integrinβ1+ /CD200+ VEGF165 gene-modified iPS-HFSCsGFP were obtained and identified by a combination of immunofluorescence and RT-qPCR. Astragalus polysaccharide-containing 3D printed degradable scaffolds were prepared and co-cultured with VEGF165 gene-modified iPS-HFSCsGFP , and the biocompatibility and spatial structure of the tissue-engineered skin was analysed by cell counting kit-8 (CCK8) assay and scanning electron microscopy. Finally, the tissue-engineered skin was transplanted onto the dorsal trauma of nude mice, and the effect of tissue-engineered skin on the regenerative repair of total skin defects was evaluated by a combination of histology, immunohistochemistry, immunofluorescence, RT-qPCR, and in vivo three-dimensional reconstruction under two-photon microscopy. CK19+ /Integrinβ1+ /CD200+ VEGF165 gene-modified iPS-HFSCsGFP , close to the morphology and phenotype of human-derived hair follicle stem cells, were obtained. The surface of the prepared 3D printed degradable scaffold containing 200 μg/mL astragalus polysaccharide was enriched with honeycomb-like meshwork, which was more conducive to the proliferation of the resulting cells. After tissue-engineered skin transplantation, combined assays showed that it promoted early vascularization, collagen and hair follicle regeneration and accelerated wound repair. VEGF165 gene-modified iPS-HFSCsGFP compounded with 3D printed degradable scaffolds containing 200 μg/mL astragalus polysaccharide can directly and indirectly participate in vascular, collagen, and hair follicle regeneration in the skin, achieving more complete structural and functional skin regenerative repair.

近节指骨骨折是较为多见的手部创伤[1],其中部分患者发生在指骨基底部,且骨折端通常向掌侧突起成角,因骨折端靠近掌指关节,治疗不当将会导致手指外观畸形和掌指关节功能障碍.对于近节指骨基底部骨折的治疗,临床大多数医者更倾向于选择手术治疗,固定方式包括克氏针、微型钢板及外固定支架等[2],各种术式都有其自身的优势和不足.本研究拟比较切开复位微型钢板内固定与闭合复位微型外固定支架固定治疗近节指骨基底部骨折的疗效,报道如下.

皮肤作为人体最大的器官,承担着防御、免疫、代谢等多种功能.而在日常生活中,急性皮肤损伤随处可见,具有发病率高、并发症多等特点[1].皮肤遭受大面积损伤后,患者会面临着感染、休克,甚至死亡的威胁.目前我国每年复杂难愈合创面治疗需求有3000万人次,而整个创面治疗的需求更是高达1亿人次[2].传统治疗方式中,中医以"清热祛腐,活血化瘀,补虚生肌"为大纲,辅以中药治疗,而西医以植皮、清创缝合、反复换药为主,但这些方案不仅治疗周期长、花费较大,而且愈合后皮瓣功能差、伤口欠美观,即使引用了负压封闭引流技术(vacuum sealing drainage,VSD),仍然可能会加重原本的积血现象,有时也可因负压时间过长导致创面干燥、坏死[3].而随着生物材料学、三维(three-dimensional, 3D)打印技术的进步,传统治疗方案中的弊端将有望被解决.本文对3D打印在创面愈合领域的研究进展进行综述,现报道如下.

There is very limited evidence linking glyphosate exposure to bone mineral density in adults aged 20 to 59 years in the National Health and Nutrition Examination Survey database. Hence, this study aimed to investigate the correlation between urinary glyphosate concentrations and total bone mineral density (BMD) in adults aged 20 to 59 years. A cross-sectional study was conducted using data from the 2013 to 2016 National Health and Nutrition Examination Survey, which included 594 men (mean age 39.1 years) and 610 women (mean age 40.0 years). In our study, we utilized a weighted multiple regression equation model to investigate the potential correlation between urinary glyphosate concentration and total BMD. Additionally, we conducted a stratified analysis to differentiate between various special populations. Our findings revealed a significant negative association between urinary glyphosate concentration and total BMD across 3 different regression models (Model 1, β [95% CI]: −0.0160 [−0.0200, −0.0120]; Model 2, β [95% CI]: −0.0135 [−0.0172, −0.0098]; Model 3, β [95% CI]: −0.0141 [−0.0178, −0.0104]). However, after stratifying by gender, age, and race, we observed varying conclusions. This study found that urinary glyphosate concentration was negatively associated with total BMD in both men and women when stratified by sex. Additionally, when stratified by age, the negative association was more significant in the 20 to 29 and 50 to 59 year age groups. When stratified by race, a significant negative association was found in races other than Hispanic. Therefore, the impact of glyphosate exposure on BMD should attract more people’s attention.

Objectives: Bone marrow mesenchymal stem cells (BMSCs) are instrumental in bone development, metabolism, and marrow microenvironment homeostasis. Despite this, the relevant effects and mechanisms of BMSCs on congenital scoliosis (CS) remain undefined. Herein, it becomes our focus to reveal the corresponding effects and mechanisms implicated. Methods: BMSCs from CS patients (hereafter referred as CS-BMSCs) and healthy donors (NC-BMSCs) were observed and identified. Differentially expressed genes in BMSCs were analyzed utilizing scRNA-seq and RNA-seq profiles. The multi-differentiation potential of BMSCs following the transfection or infection was evaluated. The expression levels of factors related to osteogenic differentiation and Wnt/beta-catenin pathway were further determined as appropriate. Results: A decreased osteogenic differentiation ability was shown in CS-BMSCs. Both the proportion of LEPR+ BMSCs and the expression level of WNT1-inducible-signaling pathway protein 2 (WISP2) were decreased in CS-BMSCs. WISP2 knockdown suppressed the osteogenic differentiation of NC-BMSCs, while WISP2 overexpression facilitated the osteogenesis of CS-BMSCs via acting on the Wnt/beta-catenin pathway. Conclusions: Our study collectively indicates WISP2 knockdown blocks the osteogenic differentiation of BMSCs in CS by regulating Wnt/beta-catenin signaling, thus providing new insights into the aetiology of CS.

Objective To investigate the association between creatinine to cystatin C ratio (CCR) and bone mineral density (BMD) in middle-aged and older adults. Methods This cross-sectional study investigated participants aged 50–85, using National Health and Nutrition Examination Survey (NHANES) data from 1999 to 2002. The correlation between CCR and total BMD was assessed by multivariate linear regression models, using stratified analysis by age, sex and race (Mexican American, other Hispanic, non-Hispanic White, non-Hispanic Black, and other race) to distinguish various special populations. Results Among 2992 patients, multiple regression models revealed a significant positive correlation between CCR and total BMD: model 1, 0.030 (95% confidence interval [CI] 0.029, 0.031); model 2, 0.009 (95% CI 0.008, 0.010); model 3, 0.010 (95% CI 0.009, 0.013). After controlling for all covariates, a positive correlation was observed between CCR and total BMD in both men and women, and was further strengthened in older age groups. When stratifying by race, the positive correlation was most significant among ‘other Hispanic’ participants; there was no significant correlation among those of ‘other race’. Conclusions A positive correlation was demonstrated between CCR and total BMD in middle-aged and older adults aged 50–85 years, with the most significant positive correlation in the older ‘other Hispanic’ population. No significant correlation was observed among participants of ‘other race’.

Here we assessed the accuracy of O-arm navigation assisted by Wiltse approach to improve based pedicle screw insertion in ankylosing spondylitis combined with thoracolumbar fractures. We then compared it with the freehand pedicle screw insertion technique. The study sample included 32 patients with ankylosing spondylitis combined with thoracolumbar fractures. Pedicle screw reduction and internal fixation was performed under an O-arm navigation system assisted by a Wiltse approach-combined osteotomy ("navigation group," n = 17) and posterior pedicle screw reduction and internal fixation was performed using freehand technique combined osteotomy ("freehand group," n = 15). We then compared the operation time and bleeding volume between the 2 groups. The visual analog scale (VAS) and Oswestry disability index (ODI) were then used to evaluate the clinical efficacy and the kyphosis Cobb angle was used to evaluate the radiological efficacy before operation, 3 days after operation and after the last follow-up. All complications were noted when detected. Finally, classification of screw positions as proposed by Neo et al was used to evaluate the relationship of the position between the screw, the bone cortex, and the incidence of screw penetration. All patients were followed up for 18 to 36 months (i.e., 24.2 ± 3.5 months). The operation time and intraoperative bleeding volume of the navigation group were significantly shorter (lower) than those of the freehand group (P < .05). In addition, Both groups showed significantly decreased VAS, ODI, and Cobb angle 3 days after the operation and at the last follow-up when compared to values recorded pre-operation. However, we found no significant difference in VAS, ODI, and Cobb angle between the 2 groups (P > .05). We identified no complications (e.g., infection, VTE/PE, or nerve injury). Moreover, the pedicle screw placement position of the navigation group was better than that of the freehand group (P < .05), and the screw cortical penetration rate was lower than the freehand group (P < .05). During the process of posterior pedicle screw placement, O-arm navigation assisted by the Wiltse approach can significantly reduce operation time, minimize the amount of bleeding volume, and enhance the accuracy of pedicle screw implantation.