Metacarpal shaft fractures require techniques that balance stability with rapid rehabilitation. Conventional crossed K‑wires are minimally invasive yet provide limited interfragmentary compression and may compromise reduction, whereas mini‑plates offer rigid fixation at the expense of larger incisions, longer operative time, and higher cost. Building on these trade‑offs, we evaluated a transverse K‑wire technique across adjacent metacarpals augmented with the Nice knot. In our cohort, this approach delivered perioperative efficiencies—no secondary surgery, shorter operative time, smaller incisions, and lower hospitalization costs—without increasing complications. Early joint mobility at 4 weeks was statistically greater with the Nice knot approach, but the effect size was small and likely of limited clinical relevance. We performed a retrospective cohort analysis of patients treated for second to fifth metacarpal shaft fractures at our institution between December 2021 and January 2025. Two groups were compared: (1) Transverse K‑wire fixation across adjacent metacarpals combined with Nice knot suture augmentation (Nice knot group) and (2) conventional open reduction and internal fixation with mini‑plates (plate group).Outcome measures included average hospitalization cost, operative time, incision length, postoperative metacarpophalangeal joint range of motion (ROM) at 2,4 and 6 weeks, grip strength recovery, time to union, Disabilities of the Arm, Shoulder and Hand (DASH) score, and complication rate. Baseline variables (age, sex, dominant‑hand involvement, preoperative waiting period) were assessed for group comparability. Baseline characteristics—including patient age, sex, dominance of the injured hand, and time from injury to surgery—did not differ significantly between the Nice knot and plate groups (all P > 0.05). Relative to the plate group, the Nice knot group had a 29.3

Background: Astragalus polysaccharide-containing 3D-printed scaffolds show great potential for cartilage defect repair. The aim of this study is to investigate their repairing role, combine them with metabolomics technology to deeply analyze the related metabolite changes, and provide a new strategy for the treatment of cartilage defects. Methods: Biocompatible astragalus polysaccharide-containing 3D-printed scaffolds were prepared. Thirty New Zealand rabbits were divided into normal, model and scaffold groups, with 10 rabbits in each group. The repair of cartilage defects by the scaffolds was evaluated by gross observation, micro-CT, HE and ABH staining after 12 weeks of intervention. The expression of VEGFA, Col2a1 and Biglycan was detected by immunofluorescence. Newly formed cartilage tissues were collected for metabolomics analysis to comprehensively evaluate the mechanism of action of astragalus polysaccharide-containing 3D-printed scaffolds in cartilage repair. Results: The recovery of cartilage defects in the scaffold group was found to be significantly better than that in the model group and comparable to that of the normal group by gross observation, micro-CT, HE and ABH staining. Immunofluorescence results showed that the expression of VEGFA, Col2a1 and Biglycan in the scaffold group was higher than that in the model group (all P < 0.05), comparable to that in the normal group. Metabolomics revealed that 29 metabolites were reversed in the scaffold group, with a reversal rate of 58%. The reversal mainly included groups of phospholipids, sphingolipids, purines, amino acids and energy metabolism-related changes. Fifteen metabolic pathways may be involved, and phospholipid and sphingolipid metabolism, fatty acid metabolism and purine metabolism are the major differential metabolic pathway change groups. Conclusion: Astragalus polysaccharide-containing 3D-printed scaffolds may accelerate cartilage collagen matrix remodeling, correct cartilage tissue metabolic disorders by promoting the expression of vascular-related factors, and ultimately promote cartilage repair.

The FK506-binding protein 14 (FKBP14) is a subfamily of immunophilins, has been implicated in various biochemical processes. However, its effects on the primary malignant bone tumor, osteosarcoma, are unclear. Here, we reported that FKBP14 may be an oncogene as it overexpressed in osteosarcoma tissues and cell lines, and FKBP14 expression was correlated with metastases, recurrence, tumor maximum diameter and poor survival time. FKBP14 was associated with the biological pathways including cell cycle, apoptosis and metastasis. Furthermore, we detected FKBP14 knockdown induced cell cycle arrest, apoptosis, invasion and adhesion in vitro. FKBP14 knockdown decreased the protein levels of PCNA, CDK1 and CCNB1 that promotes cell cycle, increased Bax, caspase-3 and caspase-7 protein involved in promoting cell apoptosis, and increased KIF4A expression as well as decreased SMC4 and TMEM33 proteins that contribute to cell invasion and adhesion. In addition, FKBP14 knockdown also caused a significant inhibition in tumor growth in vivo. Then, we found that the protein RhoA was identified as a binding partner of FKBP14. Taken together, FKBP14 may act as an oncogene in osteosarcoma via suppressing apoptosis and promoting invasion and adhesion in osteosarcoma carcinogenesis. FKBP14 may be a prognostic factor and potential target for osteosarcoma treatment.

Uncontrolled hemorrhaging resulting from trauma, surgery, and disease-associated or drug-induced blood disorders can cause significant morbidities and mortalities in civilian and military populations. Self-assembling peptide nanofibers are particularly attractive due to their rapid and efficient hemostasis, biocompatibility, and wound-healing properties. In this study, we designed two types of 12-residue peptides by using a strong fishnet-like peptide sequence and a pro-cell adhesion sequence (Arg-Gly-Asp, RGD). The peptides are HN2-X-Ser-Phe-Cys-Phe-Lys-Phe-Glu-X-Arg-Gly-Asp-OH (where X is Pro or Tyr), which dissolve in deionized (DI) water and form stable and transparent functional hydrogels. Transmission electron microscopy and scanning electron microscopy demonstrated that the two peptides self-assemble into nanowebs and nanofibers, forming a fishnet-like and three-dimensional network structure. Circular dichroism and Fourier transform infrared spectroscopy analysis demonstrated that the self-assembled peptides mainly adopt a beta-sheet structure with beta-turn and alpha-helix as auxiliary assembly growth. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay and SEM analysis showed that the cell survival rates were very good, delivering an obvious promotion of cell proliferation of fibroblasts and hepatocytes. Importantly, in vivo hemostasis delivered that the self-assembled peptide nanowebs and nanofibers had a good hemostatic effect on rat saphenous vein and liver bleeding, achieving 38 s faster hemostasis, which was better than commercial "Instantaneous" hemostatic powder. Accoupling the fast hemostasis and effective promotion of liver defect rapid repair, the peptide self-assembly strategy offers a clinically promising treatment option for life-threatening liver bleeding and serves as a renewed impetus for the development of peptide hydrogels as effective hemostatic agents.

BACKGROUND:Tillaux-Chaput tubercle fractures occur in adolescents, which are often associated with the separation of the distal tibial growth plate. These types of fractures are rare in adults and even rarer when accompanied by a rupture of the peroneus tertius muscle. Given the limited number of reported cases, there is limited clinical awareness, resulting in missed diagnoses and delayed treatment, ultimately affecting ankle function. CASE PRESENTATION:We report a case of an adult patient who experienced a right ankle injury resulting in swelling and pain after a traffic accident. Initial examination failed to identify the rupture of the peroneus tertius muscle, but the patient was observed to have restricted dorsiflexion and eversion of the foot. Surgical exploration through an anterolateral incision confirmed the rupture and the muscle was then repaired. The patient received four weeks of cast immobilization and then engaged in progressive rehabilitation exercises. DISCUSSION AND CONCLUSION:This report shares the diagnostic and therapeutic experiences of an adult with a Tillaux-Chaput tubercle fracture associated with peroneus tertius muscle rupture to improve clinical recognition of such injuries, thus preventing misdiagnosis and treatment delays.

Osteoporosis is a metabolic bone disease. β-Catenin is associated with fractures. Jian-Pi-Bu-Shen (JPBS) can promote the healing of osteoporotic fractures (OPF). However, the mechanism of β-catenin-mediated skeletal muscle satellite cells (SMSCs) in OPF by the JPBS is unclear. SMSCs were isolated and divided into five groups. The results showed that the survival rate of SMSCs was significantly higher in the low, medium, and high dose JPBS-containing serum groups after 7 days of incubation. The ALP activity and the number of SMSCs mineralized in the JPBS-containing serum intervention group were elevated. Axin, GSK-3β, β-catenin siRNAs were constructed and transfected into cells. Transfection of siRNAs reduced Axin, GSK-3β, and β-catenin expressions, respectively. β-Catenin-siRNA reversed ALP activity, the number of SMSCs mineralized, and the expression of β-catenin, BMP2, Runx2, COL-I, SP7/Ostrix, Osteocalcin, and BMP-7. Transcriptomic results suggested that the TNF signaling pathway associated with OPF was enriched. SD rats were subjected to the construction of OPF model by removing the ovaries. JPBS decreased the levels of PINP, ALP, CTX, and NTX through β-catenin in OPF rats, while increasing Runx2, β-catenin expressions through β-catenin at the broken end of fractures. Moreover, JPBS decreased BMC, BMD, and BV/TV and improved pathological damage through β-catenin in OPF rats. JPBS decreased the expression of Axin, GSK-3β mRNA, and protein, but increased the expressions of β-catenin, Pax7, COL-II, COL-II, BMP2, and Runx2 through β-catenin in OPF rats. In conclusion, JPBS inhibits Axin/GSK-3β expression, activates the β-catenin signaling, and promotes the osteogenic differentiation of SMSCs.

膝骨关节炎(KOA)是常见的骨关节退行性疾病.疼痛是KOA患者最主要的症状之一.外治法是缓解KOA疼痛的常用治疗手段,临床应用广泛且疗效确切、患者接受度高.目前临床常用的外治法主要包括针灸、冲击波、中药熏洗等.尽管外治法具有缓解KOA疼痛的效果,但对其具体作用机制尚存在分歧,本文就临床治疗KOA常用的各种外治法相关作用机制进行综述分析,为外治法的临床应用提供理论依据和治疗靶点.

Background:The bony mallet finger is a tear fracture of the extensor tendon, resulting in a flexion deformity of the finger, which affects both the function of the finger. The classical Ishiguro's method is associated with damage to the cartilage of the distal interphalangeal (DIP) joint and always lead to the joint stiffness. This paper explores a new technique to overcome the shortcomings of the classical Ishiguro's method and achieve better clinical efficacy.Methods:We examined 15 patients with bony mallet fingers, 9 males and 6 females, from February 2020 to June 2022, ranged from 23 to 58 years, including 1 case of index finger, 5 cases of middle finger, 3 cases of ring finger and 6 cases of little finger. The median course of the injury to surgery was 2 days (range, 1∼7 days). All had fresh closed injuries, according to the Wehbe and Schneider classification: 4 cases of type IA, 6 cases of type IB, 3 cases of type IIA and 2 cases of type IIB. All patients were treated surgically by the new technique. Post-operative follow-up was conducted to record the healing of the fracture, the pain of the affected finger and the function of joint movement.Results:The 15 cases were followed up after surgery. The median active range of motion was 65° (range, 55∼75°). The median extension deficit of DIP joint was 0° (range, 0∼11°). The median clinical healing time of the fracture was 6 weeks (range, 6∼10 weeks). None of the patients experienced significant pain. The patients were assessed according to the Crawford criteria at the final follow-up: 11 cases were assessed as excellent, 3 cases were assessed as good and 1 case was assessed as fair. No loss of fracture repositioning, loosening of internal fixation, skin necrosis or infection was observed.Conclusion:The application of the new technique for the treatment of bony mallet fingers has the advantages of good stability, fracture healing and functional recovery of the DIP joint, making it an ideal surgical procedure for the treatment of fresh bony mallet fingers.

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.

OBJECTIVE:To compare the clinical efficacy of micro steel plate and Kirschner needle oblique and transverse internal fixation of adjacent metacarpal bone in the treatment of metacarpal diaphyseal oblique fracture. METHODS:Fifty-nine patients with metacarpal diaphyseal oblique fractures admitted between January 2018 and September 2021 were selected as the study subjects and divided into the observation group (29 cases) and the control group (30 cases) based on different internal fixation methods. The observation group was treated with Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones, while the control group was treated with micro steel plate internal fixation. Postoperative complications, operation time, incision length, fracture healing time, treatment cost, and metacarpophalangeal function were compared between the two groups. RESULTS:No incision or Kirschner wire infections occurred in the 59 patients, except for one in the observation group. No fixation loosening, rupture, or loss of fracture reduction occurred in any of the patients. The operation time and incision length in the observation group were (20.5±4.2) min and (1.6±0.2) cm, respectively, which were significantly shorter than those in the control group (30.8±5.6) min and (4.3±0.8) cm (P<0.05). The treatment cost and fracture healing time in the observation group were (3 804.5±300.8) yuan and (7.2±1.1) weeks, respectively, which were significantly lower than those in the control group (9 906.9±860.6) yuan and (9.3±1.7) weeks (P<0.05). The excellent and good rate of metacarpophalangeal joint function in the observation group was significantly higher than that in the control group at 1, 2, and 3 months after operation (P<0.05), but there was no significant difference between the two groups at 6 months after operation (P>0.05). CONCLUSION:Micro steel plate internal fixation and Kirschner wire oblique and transverse internal fixation of adjacent metacarpal bones are both viable surgical methods for treating metacarpal diaphyseal oblique fractures. However, the latter has the advantages of causing less surgical trauma, shorter operation time, better fracture healing, lower cost of fixation materials, and no need for secondary incision and removal of internal fixation.

This study uses the knee Osteoarthritis (OA) rat (constructed by the anterior cruciate ligament transection) and the inflammatory chondrocyte (constructed by 20 ng mL −1 tumor necrosis factor‐α (TNF‐α)) to study the improvement effect of injectable β‐ecdysterone (β‐Ec) hydrogel consisting of poly (D, L‐lactic‐co‐glycolic acid)‐hyaluronate (HA‐β‐Ec‐Gel) on cartilage damage. The results show that the HA‐β‐Ec‐Gel improves the three‐dimensional of bone structure. The HA‐β‐Ec‐Gel treatment improves cartilage tissue injury of OA rats. It advances the levels of autophagic factor Beclin1 (Beclin1) and microtubule–associated protein 1 light chain 3 (LC3) in cartilage tissue. The lysyl oxidase like 3 (LOXL3), ras homologue enriched (Rheb), phosphorylated (p)‐V–akt murine thymoma viral oncogene homolog (AKT)/AKT, and p‐mechanistic target of rapamycin (mTOR)/mTOR signal expression are inhibited by HA‐β‐Ec‐Gel intervention. In inflammatory chondrocytes, β‐Ec improves the cell viability, autophagosome numbers, and Beclin1 and LC3 II/I levels, also inhibits apoptotic rate, LOXL3 and Rheb expression levels, and the AKT/mTOR pathway. The 3‐methyladenine addition reverses these effects of β‐Ec. The Rheb or LOXL3 knockdown chondrocytes aren't sensitive to TNF–α‐induced damage. Their autophagy level is high. This study reveals the improvement effects of injectable HA‐β‐Ec‐Gel on OA, which provides a scientific basis and new direction for the development of OA treatment strategies.

目的 探讨β-蜕皮甾酮通过调控β-catenin/BMP表达促进骨髓间充质干细胞分化治疗骨质疏松性骨折的作用及相关机制.方法 选取3个月龄雌性TOPGAL小鼠,建立去卵巢骨质疏松小鼠模型,于去卵巢术后3个月建立胫骨骨折模型,随机均分为空白对照组、β-蜕皮甾酮组和仙灵骨葆组,每组10只,骨折术后第2天分别给予0.9％氯化钠溶液及相应药物灌胃治疗,连续灌胃治疗4周后取标本进行相关指标检测,比较各组小鼠血清雌二醇含量、胫骨影像学改变、病理组织学改变以及骨痂中骨形成蛋白-7(BMP-7)、β-连环蛋白(β-catenin)的表达水平.结果 血清雌二醇含量检测结果显示,β-蜕皮甾酮组及仙灵骨葆组血清中雌二醇含量分别为(8.14±4.19)pg/mL、(12.23±4.92)pg/mL,均明显高于空白对照组(3.27±3.40)pg/mL(P<0.05).X线检测结果显示,空白对照组骨折端少量稀疏骨痂通过和少量外骨痂形成,骨折线可见;而β-蜕皮甾酮组和仙灵骨葆组骨折端外骨痂致密,部分髓腔再通,骨折线模糊.Micro-CT结果显示,空白对照组骨皮质厚度明显变薄,骨小梁稀疏;β-蜕皮甾酮组与仙灵骨葆组骨皮质厚度明显优于空白对照组,骨小梁结构相对紧密、均匀.HE染色发现,β-蜕皮甾酮组和仙灵骨葆组小鼠骨小梁数量、密度均得到明显改善,骨痂形状更为规则,与骨皮质贴合程度更高,其中以β-蜕皮甾酮组效果最佳.免疫组化染色发现,β-蜕皮甾酮组和仙灵骨葆组BMP-7、β-catenin表达阳性水平明显高于空白对照组,染色较深,但以β-蜕皮甾酮的密集度更高,染色更深.结论 β-蜕皮甾酮可通过增强BMP-7、β-catenin表达促进BMSCs定向分化,发挥治疗骨质疏松性骨折的作用.

目的:运用改良的乳液聚合法制备芍药苷-聚氰基丙烯酸正丁酯微球,并测定载药微球的各项理化性质,绘制释放度曲线.方法:运用改良的乳液聚合法制备芍药苷-聚氰基丙烯酸正丁酯微球,在扫描电镜下观察其形状形态,利用公式计算其包封率及载药量.将微球溶解于PBS缓冲液及生理盐水后,运用分光光度法测定不同时间微球释放的药物浓度,绘制释放度曲线.结果:运用改良的乳液聚合法制备芍药苷-聚氰基丙烯酸正丁酯微球过程顺利,扫描电镜下观察,微球表面光滑,形状规整,形态均一饱满,分布均匀.微球包封率(88.9±6.1)％,载药量(12.6±0.86)％,体外释放突释效应不明显,40 d累积释放药量在pH为7.0的PBS缓冲液中为(82.778±4.65)％,在生理盐水中为(71.812±4.78)％.结论:聚氰基丙烯酸正丁酯微球可以作为芍药苷理想的缓释载体,其包封率适宜,体外释放性能较好,突释效应小,缓释性良好.聚氰基丙烯酸正丁酯微球能够延长芍药苷药物的作用时间,减少用药次数,在临床上有较好的应用前景.