In order to provide a more effective method to describe the local structure of the degraded image and to enhance the robustness of the denoising, we propose a non-convex total variational image denoising model that combines the non-convex log function with an adaptive weighted matrix within the total variation framework. In the proposed model, the weighted matrix is capable of effectively describing the primary direction of the edge structure, based on the coupling of the gradient operator of the denoising image and the diagonal matrix. As the proposed model is a non-convex and non-smooth optimisation problem, the iterative reweighted 81algorithm and alternating direction multiplier method are employed to decompose it into a number of readily solvable sub-problems. The results obtained from numerical experiments demonstrate that the proposed model is capable of effectively suppressing the noise while maintaining the local structure of the image.

Objective:To investigate the effect of fibulin-3 on the senescence of intervertebral disc nucleus pulposus cells (NPCs) through the regulation of tissue inhibitor of metalloproteinases 3 (TIMP-3) expression and to elucidate the molecular mechanisms involved. Methods:1). The nucleus pulposus tissues and imaging data of 37 patients who had undergone intervertebral disc surgery were collected. The degree of degeneration of the intervertebral discs were classified according to the Pfirrmann grading system. The senescence degree of NPCs was determined using senescence-associated β-galactosidase (SA-β-gal) staining. Fibulin-3 expression levels were determined using Western blot and ELISA. The relationship between fibulin-3 and disc degeneration and NPCs senescence was investigated. 2). Human intervertebral disc NPCs were cultured in vitro. The proliferation and senescence of NPC across continuous passage were observed via CCK-8 assay and SA-β-gal staining, respectively. Fibulin-3 expression levels and the expression of inflammatory cytokines and matrix metalloproteinases were assessed. Exogenous fibulin-3 was added to verify its effect on the proliferation and senescence of NPCs. 3). The effect of fibulin-3 on the apoptosis and proliferation of NPCs was verified through gene overexpression, which was used in combination with an apoptosis inhibitor for bidirectional verification. 4). Bioinformatics analysis was performed to explore the relationship between fibulin-3 and the TIMP family. Experiments overexpressing fibulin-3 and silencing the TIMP-3 gene were performed to verify their role in NPCs senescence. Results:1). The intervertebral disc degeneration samples from 37 patients were classified according to the Pfirrmann grading system. The higher the degeneration grade, the lower fibulin-3 expression. Spearman correlation analysis showed that the disc grade was negatively correlated with the NPC senescence grade (r=－0.87, P<0.001) and fibulin-3 expression (r=－0.79, P<0.001). 2). As the passage number of NPCs increased, fibulin-3 expression gradually decreased, cell proliferation ability weakened, and the expression of inflammatory cytokines and matrix metalloproteinases increased. After exogenous fibulin-3 was added, cell morphology and growth status were maintained, cell senescence was significantly inhibited, and the expression of inflammatory cytokines and matrix metalloproteinases was markedly reduced. 3). Gene overexpression experiments showed that fibulin-3 reduced NPC apoptosis and promoted cell proliferation, thereby inhibiting NPC senescence. 4). Bioinformatics analysis revealed a significant association between fibulin-3 and TIMP-3 of the TIMP family. Further experiments confirmed that overexpressing fibulin-3 enhanced TIMP-3 expression, while silencing the TIMP-3 gene significantly weakened the inhibitory effect of fibulin-3 on NPCs senescence. This indicates that, through regulating TIMP-3, fibulin-3 inhibits the activity of matrix metalloproteinases, affects the synthesis and degradation of the extracellular matrix, and ultimately inhibits NPCs senescence. Conclusion:This study demonstrates that fibulin-3 plays a crucial role in inhibiting the senescence of intervertebral disc NPCs by regulating TIMP-3. The specific mechanisms involved are as follows, fibulin-3 upregulates TIMP-3 expression, inhibits matrix metalloproteinase activity, and reduces extracellular matrix degradation, thereby promoting extracellular matrix synthesis. Additionally, fibulin-3 inhibits NPCs senescence by reducing apoptosis and promoting cell proliferation. Therefore, fibulin-3 and TIMP-3 have potential therapeutic significance in maintaining intervertebral disc health and delaying degeneration.

BACKGROUND:Magnetic resonance imaging (MRI) is a handy diagnostic tool for orthopedic disorders, particularly spinal and joint diseases. METHODS:The lumbar intervertebral disc is visible in the T1 and T2 weight sequences of the spine MRI, which aids in diagnosing lumbar disc herniation, lumbar spine tuberculosis, lumbar spine tumors, and other conditions. The lumbar intervertebral disc cannot be seen accurately in the Spectral Attenuated Inversion Recovery (SPAIR) due to weaknesses in the fat and frequency offset parameters, which is not conducive to developing the intelligence diagnosis model of medical image. RESULTS:In order to solve this problem, we propose a composite framework, which is first to use the contrast limited adaptive histogram equalization (CLAHE) method to enhance the SPAIR image contrast of the spine MRI and then use the non-local means method to remove the noise of the image to ensure that the image contrast is uniform without losing details. We employ the Information Entropy (IE), Peak signal-to-noise ratio (PSNR), and feature similarity index measure (FSIM) to quantify image quality after enhancement by the composite framework. CONCLUSION:The outcomes of the experiments' output images and quantitative data indicate that our composite framework is better than others.

继循证医学、转化医学之后,学者们积极推动了精准医学理念的发展.近年来,随着人工智能、计算机图像导航、机器人控制等学科的交叉融合,骨科手术机器人的研究日趋成熟,目前已成为脊柱外科高风险、高难度手术及微创手术的核心智能产品,为国家专项计划支持推广的医疗装备.研究表明,经手术机器人辅助下的穿刺、通道建立及置钉等操作,显著地提升了操作的精准性,减少了手术二次创伤,降低了术中神经损伤的风险,对脊柱外科的发展具有里程碑式的意义.本文通过检索国内外脊柱手术机器人相关文献报道,对其具有明显应用优势的相关术式进行了介绍,并分析其不足之处的原因及对应策略.

This study aimed to explore the effect of a nanomaterial-based miR-320a inhibitor sustained release system in trauma-induced osteonecrosis of the femoral head (TIONFH). The miR-320a inhibitor-loaded polyethylene glycol (PEG)- Poly(lactic-co-glycolic acid) (PLGA)- Poly-L-lysine (PLL) nanoparticles were constructed using the double emulsion method. The TIONFH rabbit model was established to observe the effects of miR-320a inhibitor nanoparticles in vivo. Hematoxylin–eosin staining and microcomputed tomography scanning were used for bone morphology analysis. Bone marrow mesenchymal stem cells (BMSCs), derived from TIONFH rabbits, were used for in vitro experiments. Cell viability was determined using the MTT assay. High expression of miR-320a inhibited the osteogenic differentiation capacity of BMSCs in vitro by inhibiting the expression of the osteoblastic differentiation markers ALP and RUNX2. MiR-320a inhibitor-loaded PEG-PLGA-PLL nanoparticles were constructed with a mean loading efficiency of 1.414 ± 0.160

目的:对诊断腰椎间盘突出MRI 影像条目权重开展研究,以形成优化统一的影像诊断路径.方法:提取文献中关于腰椎间盘突出MRI影像诊断的语句、关键词和相关词汇建立条目池,采用头脑风暴法对条目进行讨论,将讨论后的条目结合Likert 5 级重要性分级构建问卷,使用德尔菲法开展专家咨询,并依据咨询结果计算诊断腰椎间盘突出MRI 影像条目的权重系数,通过对权重系数排序以形成影像诊断路径.结果:本研究形成的影像诊断路径如下:神经根受压(LNRC)、髓核水分(LNPM)、椎间盘形态与高度(LDMAH)、脑脊液通畅情况(CFP)、马尾神经走行(CEL)、纤维环完整性(LDFRI)、后纵韧带完整性(PLLI)、髓核与纤维环分界(NPAFRD)、椎体稳定性(LVBS)、终板形态(LEM)、骨质增生(LVO)、Modic改变(MC)及Schmorl结节(SN).结论:本研究的腰椎间盘突出MRI影像诊断路径能为影像智能诊断提供基础条件,并为相关影像研究提供参考.

Background: We aimed to explore the molecular mechanisms underlying the effect of Gugutouhuaisiyu Capsule (GGTHSYC) on traumatic osteonecrosis of the femoral head (ONFH) using rabbit models.Methods: New Zealand rabbits (n = 24) were randomly placed into the control, model, and 30 and 60 mg/kg GGTHSYC treatment groups. Animals in the model and GGTHSYC treatment groups were subjected to surgically induced ONFH. Rabbits in the 30 and 60 mg/kg GGTHSYC treatment groups were administered GGTHSYC via the gastrointestinal route. MRI (magnetic resonance imaging) was employed to assess osteonecrosis. The mRNA and protein expression levels of BMP-2 (bone morphogenetic protein 2), RUNX2 (runt related transcription factor 2), VEGF (vascular endothelial growth factor), HIF-1a (hypoxic-induced factor-1a), and OPG (osteoprotegerin) in femoral head tissues were measured using reverse transcription-quantitative polymerase chain reaction and western blotting and immunochemistry, respectively.Results: GGTHSYC significantly enhanced osteocalcin activities in rabbits with traumatic ONFH by increasing ALP (alkaline phosphatase) expression (p = 0.008). Administration of GGTHSYC also significantly increased the mRNA and protein levels of HIF-1, VEGF, RUNX2, BMP-2, OPG, and BSP (bone sialoprotein) (p < 0.05).Conclusions: Administration of GGTHSYC improved bone regeneration following traumatic ONFH, which was accompanied by increased expression of the transcription factors HIF-1a and RUNX2 as well as other related proteins, suggesting that the transcription factors HIF-1a and RUNX2 may be a potential target for the treatment of traumatic ONFH.

目的 分析腰椎间盘突出症患者发生下肢深静脉血栓的影响因素,探讨建立的列线图模型对下肢深静脉血栓的术前预测价值.方法 2019年7月-2022年7月河南省洛阳正骨医院拟行手术治疗的腰椎间盘突出症患者862例,入院后均行超声检查下肢深静脉血栓发生情况.将862例患者根据收治病区分为训练集596例,验证集266例.收集训练集和验证集患者临床资料,包括性别,年龄,体质量指数,病程及红细胞计数、白细胞计数、血小板计数、三酰甘油、总胆固醇、D-二聚体水平,椎间盘退变Pfirrmann分级,骨密度,视觉模拟评分等;采用单因素logistic回归和lasso回归分析筛选训练集患者发生下肢深静脉血栓的影响因素,纳入多因素logistic回归分析模型,分析其发生下肢深静脉血栓的危险因素;根据多因素logistic回归分析结果建立预测腰椎间盘突出症患者发生下肢深静脉血栓的列线图模型;采用ROC曲线、校准曲线及决策曲线评估该模型预测训练集和验证集患者发生下肢深静脉血栓的价值,比较列线图模型与D-二聚体预测验证组患者发生下肢深静脉血栓的效能.结果 862例患者中发生下肢深静脉血栓170例,其中训练集115例,验证集55例.训练集性别、年龄、体质量指数、病程、视觉模拟评分、合并症、药物服用情况、手术史、实验室检查结果、Pfirrmann分级等与验证集比较差异均无统计学意义(P＞0.05).年龄＞48岁(OR=18.724,95％CI:5.386～65.080,P＜0.001),D-二聚体＞0.5 mg/L(OR=1.367,95％CI:1.051～1.992,P＜0.001)、体质量指数＞30 kg/m2(OR=2.226,95％CI:1.707～3.829,P=0.004)、总胆固醇＞5.2 mmol/L(OR=-1.065,95％CI:-1.649～-1.016,P＜0.001)、白细胞计数＞10×109/L(OR=2.134,95％CI:1.673～3.855,P=0.007)、红细胞计数＜4.3× 1012/L(OR=-0.474,95％CI:-0.995～0.041,P=0.042)是训练集患者发生下肢深静脉血栓的危险因素.列线图模型最佳截断值为1.729时预测训练集患者发生下肢深静脉血栓的AUC为0.822(95％CI:0.784～0.861,P＜0.001),灵敏度为90.1％,特异度为79.6％;列线图预测验证集患者发生下肢深静脉血栓的AUC(0.807)大于D-二聚体(0.616)(Z=-3.371,P=0.001);列线图在验证集和训练集校准曲线均与理想曲线基本接近,决策曲线均远离横纵坐标,预测腰椎间盘突出症患者发生下肢深静脉血栓的净收益均高于D-二聚体.结论 年龄＞48岁、D-二聚体＞0.5 mg/L、体质量指数＞30 kg/m2、总胆固醇＞5.2 mmol/L、白细胞计数＞10×109/L、红细胞计数＜4.3×1012/L是腰椎间盘突出症患者发生下肢深静脉血栓的危险因素,构建的列线图模型术前预测腰椎间盘突出症患者下肢深静脉血栓的价值较高.

Objective:To observe the clinical efficacy of deflected supine traction combined with Chinese herbal steaming in the treatment of cervical spondylotic radiculopathy（CSR）.Methods:A total of 120 CSR patients were randomly divided into a deflected supine traction（DST）group, a conventional supine traction（CST）group, and a sitting traction（ST）group, with 40 cases in each group.The supine traction consisted of traction in the forward flexion position for 8 days, in the neutral position for 2 days, and in the back flexion position for 4 days.In the DST group, DST was adopted in the traction in the forward flexion position, and CST was adopted in the traction in the neutral position and back flexion position.In the CST group, CST was employed throughout the whole treatment cycle.In the ST group, conventional intermittent ST was employed.All patients were treated with Chinese herbal steaming.Traction and Chinese herbal steaming were performed twice a day for 14 days.Before and after treatment, the visual analogue scale（VAS）was used to evaluate the cervical pain of patients, and ranges of motion in cervical rotation and cervical flexion were measured.The clinical efficacy was evaluated by the Yasuhisa Tanaka 20 Score Scale and neck disability index（NDI）.Young’s modulus of trapezius muscle was measured by shear wave elasticity imaging（SWEI）.Results:（1）Cervical pain VAS score.After treatment, cervical pain VAS scores in all groups were lower than those before treatment（5.70±0.82 vs 1.43±0.68 points, t=37.779,P=0.000;5.43±0.81 vs 2.53±0.93 points, t=15.945,P=0.000;5.43±0.98 vs 3.00±1.13 points, t=16.013,P=0.000）.The cervical pain VAS score in the DST group was lower than those in the CST group and the ST group（LSD-t=6.040,P=0.000;LSD-t=7.562,P=0.000）.The cervical pain VAS score in the CST group was lower than that in the ST group（LSD-t=2.051,P=0.044）.（2）Range of motion in cervical rotation.After treatment, ranges of motion in cervical rotation in all groups were greater than those before treatment（46.60°±10.45° vs 63.65°±7.79°,t=-9.379,P=0.000;45.95°±9.24° vs 57.58°±7.54°,t=-6.694,P=0.000;48.22°±9.96° vs 53.72°±9.39°,t=-2.298,P=0.000）.The range of motion in cervical rotation in the DST group was greater than those in the CST group and the ST group（LSD-t=-3.280,P=0.001;LSD-t=-5.371,P=0.000）.The range of motion in cervical rotation in the CST group was greater than that in the ST group（LSD-t=-2.083,P=0.040）.（3）Range of motion in cervical flexion.After treatment, the ranges of motion in cervical flexion in all groups were greater than those before treatment（28.45°±3.18° vs 41.57°±2.88°,t=-18.310,P=0.000;27.70°±3.07° vs 38.95°±3.38°,t=-16.843,P=0.000;28.15°±3.30° vs 35.25°±3.80°,t=-9.692,P=0.000）.The range of motion in cervical flexion in the DST group was greater than those in the CST group and the ST group（LSD-t=-3.482,P=0.001;LSD-t=-8.374,P=0.000）.The range of motion in cervical flexion in the CST group was greater than that in the ST group（LSD-t=-4.901,P=0.000）.（4）Yasuhisa Tanaka 20 Score Scale score.After treatment, Yasuhisa Tanaka 20 Score Scale scores in all groups were higher than those before treatment（7.58±3.87 vs 16.10±2.04 points, t=-14.437,P=0.000;7.38±3.31 vs 13.25±2.10 points, t=-12.361,P=0.000;7.25±2.9 vs 12.65±2.70 points, t=-10.696,P=0.000）.The Yasuhisa Tanaka 20 Score Scale score in the DST group was higher than those in the CST group and the ST group（LSD-t=-6.172,P=0.001;LSD-t=-6.450,P=0.000）.There was no statistically significant difference in Yasuhisa Tanaka 20 Score Scale score between the CST group and the ST group（LSD-t=-1.113,P=0.271）.（5）NDI.After treatment, NDI in all groups was lower than that before treatment（49.85±15.29 vs 18.93±12.05%,t=10.694,P=0.000;51.73±15.31 vs 29.95±9.08%,t=10.728,P=0.000;53.10±12.67 vs 33.85±10.33%,t=7.190,P=0.000）.The NDI in the DST group was lower than those in the CST group and the ST group（LSD-t=4.622,P=0.001;LSD-t=5.951,P=0.000）.There was no statistically significant difference in NDI between the CST group and the ST group（LSD-t=1.790,P=0.077）.（6）Young’s modulus of trapezius muscle.After treatment, Young’s modulus of trapezius muscle in all groups was lower than those before treatment（92.67±17.96 vs 62.80±13.35%,t=14.696,P=0.000;87.05±12.30 vs 77.03±13.10%,t=5.959,P=0.000;87.33±14.48 vs 82.58±15.81%,t=2.337,P=0.025）.The Young’s modulus of trapezius muscle in the DST group was lower than those in the CST group and the ST group（LSD-t=4.811,P=0.001;LSD-t=6.044,P=0.000）.There was no statistically significant difference in Young’s modulus of trapezius muscle between the CST group and the ST group（LSD-t=1.711,P=0.091）.Conclusion:In the treatment of CSR,DST combined with Chinese herbal steaming can relieve cervical pain and improve cervical function and trapezius muscle stiffness, and the efficacy is superior to those of CST and ST combined with Chinese herbal steaming.

目的:评价针刀疗法治疗膝骨关节炎(knee osteoarthritis,KOA)的临床疗效.方法:应用计算机检索万方医学数据库、中国知网、维普资讯、PubMed及The Cochrane Library数据库,检索其中关于针刀疗法治疗KOA的随机对照临床试验文献,检索时间范围均为建库至2020年12月31日.中文检索词包括"针刀""小针刀""膝骨关节炎""膝骨性关节炎""膝关节骨性关节炎";英文检索词包括"small needle knife""needle knife""knee osteoarthritis".针刀组的主要干预措施为普通针刀治疗,针刺组的主要干预措施为普通针刺治疗,两组均可联合应用其他相同的非手术疗法.按照事先确定的文献纳入和排除标准筛选文献,提取入选文献中的相关数据.以Cochrane偏倚风险评估工具对纳入的各项研究进行质量评价后,采用Review Manager 5.4.1软件进行Meta分析和发表偏倚分析.结果:①文献检索及质量评价:共纳入20篇随机对照临床试验文献,均为中文文献,共涉及2 068例患者,其中针刀组1 035例、针刺组1 033例;Cochrane偏倚风险评估工具的评价结果显示,纳入文献的方法学质量普遍较低.②Meta分析:针刀组的治疗有效率高于针刺组[x2=11.920,P=0.610,I2=0％,RR=1.16,95％CI(1.11,1.22),P=0.000];进一步亚组分析显示,采用《中医病证诊断疗效标准》评价治疗有效率的7篇文献和采用《中药新药临床研究指导原则》评价治疗有效率的8篇文献,针刀组的治疗有效率也均高于针刺组[《中医病证诊断疗效标准》:x2=6.440,P=0.380,I2=7％,RR=1.17,95％CI(1.08,1.26),P=0.000;《中药新药临床研究指导原则》:x2=5.420,P=0.610,12=0％,RR=1.16,95％CI(1.09,1.23),P=0.000].针刀组治疗后的膝关节疼痛视觉模拟量表评分低于针刺组[x2=94.340,P=0.000,I2=89％,MD=-1.24,95％CI(-1.58,-0.90),P=0.000].针刀组治疗后的西安大略和麦克马斯特大学骨关节炎指数低于针刺组[x2=42.690,P=0.000,12=88％,MD=-9.06,95％CI(-13.34,-4.78),P=0.000].③发表偏倚分析:基于治疗有效率的漏斗图显示,纳入的各项研究分布不完全对称,不排除存在发表偏倚的可能.结论:针刀疗法是治疗KOA的有效方法,其疗效优于针刺疗法.

目的 探讨骨炎膏对大鼠感染性创面愈合的影响及可能作用机制.方法 选取72只SPF级SD大鼠,随机取18只作为正常创面组,其余大鼠采用外科手术联合接种金黄色葡萄球菌液方法制备感染性创面模型.将造模成功大鼠随机分为感染创面组、骨炎膏组、京万红组,每组18只.于制备创面后第1天开始,正常创面组及感染创面组大鼠创面予生理盐水棉球擦拭后无菌纱布包扎固定,京万红组创面涂抹适量京万红软膏(约2 g)后予无菌纱布包扎固定,骨炎膏组创面给予涂抹骨炎膏无菌纱布包扎固定,每天换药1次,直至创面完全愈合.观察并记录各组大鼠造模后第3天、第7天、第14天创面愈合面积及大鼠创面完全愈合时间;分别于造模后第3天、第7天、第14天随机取各组大鼠创面组织,使用酶联免疫法(ELISA)检测创面组织中肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)含量.结果 造模后第7天、第14天,骨炎膏组和京万红组大鼠创面愈合率均明显高于感染创面组(P 均<0.05),且骨炎膏组均明显高于京万红组(P 均<0.05).骨炎膏组和京万红组大鼠创面愈合时间均明显短于感染创面组(P均<0.05),且骨炎膏组明显短于京万红组(P<0.05).造模后第3天、第7天、第14天,感染创面组、骨炎膏组及京万红组大鼠创面组织中TNF-α、IL-6含量均明显高于正常创面组(P均<0.05);造模后第7天、第14天,骨炎膏组及京万红组大鼠创面组织中TNF-α、IL-6 含量均明显低于感染创面组(P均<0.05),且骨炎膏组均明显低于京万红组(P均<0.05).结论 骨炎膏可明显促进大鼠感染性创面愈合,缩短创面愈合时间,其机制可能与下调创面TNF-α、IL-6表达水平,减轻创面局部炎症有关.

Decreased muscle stiffness could reduce musculotendinous injury risk in sports and rehabilitation settings. Static stretching (SS) has been used to increase the flexibility of muscles and reduce muscle stiffness, but the effects of SS on the stiffness of specific regions of the knee extensor mechanism are unclear. The quadriceps femoris and patellar tendon are essential components of the knee extensor mechanism and play an important role in knee motion. Therefore, we explored the acute and prolonged effects of SS on the stiffness of the quadriceps femoris and patellar tendon and knee flexion range of motion (ROM). Thirty healthy male subjects participated in the study. Three 60-s SS with 30-s intervals were conducted in right knee flexion with 30° hip extension. We measured the ROM and stiffness of the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) and the proximal-(PPT), middle-(MPT), and distal-(DPT) region stiffness of the patellar tendon before and immediately after SS intervention, or 5 and 10 min after SS. The stiffness of the quadriceps muscle and patellar tendon were measured using MyotonPRO, and the knee flexion ROM was evaluated using a medical goniometer. Our outcomes showed that the ROM was increased after SS intervention in all-time conditions (p < 0.01). Additionally, the results showed that the stiffness of RF (p < 0.01) and PPT (p = 0.03) were decreased immediately after SS intervention. These results suggested that SS intervention could be useful to increase knee flexion ROM and temporarily reduce the stiffness of specific regions of the knee extensor mechanism.

Our study showed that Signal transducer and activator of transcription (STAT)1 and STAT3 phosphorylation was firstly upregulated in the early stage of osteogenic differentiation (OD), and quickly eliminated in hours. Following with phosphorylation of STAT1/3, its downstream feedback regulator Suppressor of cytokine signaling 1 (SOCS1) protein also underwent a quick elevation. Further activation and deactivation of STAT1/3, by administrated with Colivelin and Nifuroxazide in Bone mesenchymal stem cells (BMSCs), increased and decreased SOCS1 expression, inhibited and promoted OD of BMSCs, respectively, as evidenced by Alizarin staining, alkaline phosphatase (ALP) activity, and determination of Run-related transcription factor 2 (RUNX2), Osteocalcin (OCN), ALP, and Bone sialoprotein (BSP). In addition, administration of Colivelin and Nifuroxazide caused and blocked inflammation and apoptosis of BMSCs. To further elucidate the role of STAT1/3-SOCS1 regulatory loop on OD of BMSCs, we overexpressed or silenced SOCS1 in BMSCs during OD. WB data showed that overexpression of SOCS1 repressed STAT1/3 phosphorylation, and knockdown of SOCS1 increased the phosphorylated STAT1/3. Further mechanism study showed that OD of BMSCs was elevated or reduced by SOCS1 overexpression or knockdown, respectively. The findings presenting indicated that the STAT1/3-SOCS1 axis may be exploited as an innovative strategy to enhance osteogenesis in regenerative medicine.

[目的]评价经直前入路(direct anterior approach,DAA)高位头颈开窗植骨治疗"围塌陷期"股骨头坏死的临床疗效.[方法]回顾性分析2015年9月一2018年3月股骨头坏死患者32例(37髋)的临床资料,均采取DAA入路,头颈部带部分软骨高位开窗清除坏死骨并自体骨打压植骨.观察临床与影像结果.[结果]所有患者均顺利完成手术,术中无神经、血管损伤等严重并发症.随访(35.23±10.35)个月,随访过程中,5例(5髋)临床症状加重,其中2髋改行THA,判定为保髋失败,占13.51％;27例(32髋)临床症状持续改善,判定为保髋成功,占86.49％.与术前相比,末次随访时髋关节疼痛VAS评分显著降低(P＜0.05).而Harris评分、髋关节屈曲、内旋、外旋ROM均显著增加(P＜0.05).影像方面,与术前比较,末次随访坏死面积、关节面塌陷情况、关节间隙变窄情况无显著变化(P＞0.05).[结论]经DAA高位头颈开窗植骨治疗"围塌陷期"股骨头坏死仍可取得较好临床效果.

目的:探讨壮骨活血汤抑制内质网应激(ERS)介导的人软骨细胞凋亡防治膝关节骨性关节炎(KOA)的机制.方法:采用人软骨细胞制作ERS模型,分为对照组、衣霉素组、衣霉素+4-PBA组、衣霉素+含药血清组,检测细胞凋亡、炎症因子和炎症相关通路蛋白激酶B(AKT)与核因子κB(NF-κB)活化情况,探索ERS调控的凋亡相关信号通路活化情况.结果:衣霉素可以明显诱导人软骨细胞凋亡,而壮骨活血汤含药血清可以抑制衣霉素的促凋亡作用(P＜0.05).衣霉素+含药血清组中白细胞介素-1β(IL-1β)及肿瘤坏死因子-α(TNF-α)表达显著低于衣霉素组(P＜0.05).壮骨活血汤含药血清能减轻衣霉素诱导的炎症相关通路的活化,并且可以明显抑制ERS相关凋亡通路活化.结论:壮骨活血汤可能通过抑制ERS相关凋亡通路活化降低人软骨细胞凋亡,进而发挥治疗KOA的作用.

Background Diabetes is a chronic metabolic disease characterized by hyperglycemia that often occurs in adults. Many studies have indicated that exercise is beneficial to the medical management of diabetes. Bibliometric analysis can help investigators to identify the current research concerns to guide future research directions. Nevertheless, the overview bibliometric analysis of this global research topic related to exercise and diabetes is lacking. The present bibliometric study aimed to investigate development trends and research hotspots of exercise and diabetes research and provide researchers with new perspectives in further studies. Materials and Methods The articles and reviews regarding exercise and diabetes between 2000 and 2020 were retrieved from the Web of Science Core Collection. The scientometrics analytical tool CiteSpace software was used to analyze the cooperation among countries/institutions/journals/authors, analysis of co-occurrence keywords, keywords bursts, and references. Results In all, 3,029 peer-reviewed papers were found with a persistently increased tendency over time. The most prolific country and institution were the USA (965) and Univ Alberta (76), respectively. Diabetes Care published most papers (178) and was the most co-cited journal (2,630). Riddell MC had the most publications (53), and Sigal RJ was the most influential author (503 cited times). Colberg et al.'s paper (co-citation counts: 183) showed the strongest citation bursts by the end of 2020, which was the most representative reference. The four research focuses were mellitus, exercise, physical activity, and glycemic control. The two frontiers trends were sedentary behavior and stress. The combination of aerobic and resistance training can effectively improve glycemic control, decrease HbA1c levels, enhance cardiorespiratory fitness, improve lipid levels, and decrease the demand for non-insulin antihyperglycemic agents. Conclusions This study offers a scientific perspective on exercise and diabetes research and provides investigators with valuable information to detect the current research condition, hotspots, and emerging trends for further study.

腰痛(low back pain,LBP)是常见的肌肉骨骼疾患,有结果显示高达2/5的青年人有腰痛病史[1].有关腰痛的研究以往大多集中在腰背部及深层肌肉硬度[2],而较少有与腹部及浅层肌肉弹性模量值相关报道.有研究报道,肌肉组织功能状态的失衡是导致腰痛的重要因素[3].有研究表明,腰痛患者腹部肌群力度为健康人的2/3[4],因而腹肌的肌力不佳可能导致慢性腰痛.

Aims: The involvement of several microRNAs (miRNAs) in osteogenic differentiation has been indicated recently. Also, exosomes, derived from different cells, could shuttle specific miRNAs to other cell systems. Nevertheless, the effect and mechanism of microRNA-935 (miR-935)-containing exosomes in osteoblasts remain basically unclear. The current work was set to inspect the relevance of bone marrow mesenchymal stem cells (BMSCs)derived exosomes (BMSC-exo) carrying miR-935 to osteoporotic rats. Methods: The extracted BMSCs and purchased osteoblasts were cultured, followed by exosome isolation and identification. After cell grouping, osteoblasts were co-cultured with BMSCs. CCK-8, alizarin red staining as well as ALP staining were performed to detect osteoblast proliferation and activity. The binding connection between miR-935 and signal transducer and activator of transcription 1 (STAT1) was measured by dual-luciferase reporter gene assays. The expression profiles of miR-935, STAT1 and osteoblast-related proteins were assessed by RT-qPCR and Western blot. A rat model with osteoporosis was induced, and the BMD, BV/TV, Tb.N, Tb.Th and Tb.Sp values in rat bone tissues were observed by Micro-CT. Results: BMSC-exo inhibited STAT1 levels by the delivery of miR-935 into osteoblasts, while STAT1 silencing promoted ALP activity in osteoblasts and mineralized nodules. STAT1 was identified as a target gene of miR-935. Moreover, in vivo experiments showed that in ovariectomized rats, silencing of miR-935 significantly reduced BMD, BV/TV, Tb.N, Tb.Th and increased Tb.Sp. Conclusion: BMSC-exo carry miR-935 to promote osteoblast proliferation and differentiation through targeting STAT1.

背景:在后pilon骨折中,对于后内侧骨折块移位明显,累及内踝前丘或完全内踝骨折,或存在Die-punch骨块的复杂骨折,传统体位及手术入路常存在骨折显露不充分及复位困难等问题.目的:探讨俯卧位下后内侧改良L形切口治疗复杂后pilon骨折的手术技巧及临床疗效.方法:选取2016年5月至2018年12月收治的复杂后pilon骨折患者17例,男10例,女7例,年龄23～66岁,平均(49.2±12.1)岁.合并Die-punch骨块9例,累及内踝后丘部骨折5例,累及内踝前丘骨折8例,完全内踝骨折4例.均采用俯卧位下后内侧改良L形切口切开复位内固定治疗,记录手术时间、出血量及骨折愈合时间,通过踝关节X线、CT扫描评估骨折复位情况,随访评估患肢功能及并发症发生情况.末次随访采用美国足踝外科协会(AOFAS)踝-后足功能评分标准、VAS评分及伸膝状态下踝关节活动度(ROM)进行临床疗效评价.结果:17例患者随访12～25个月,平均(15.6±3.5)个月;手术时间110～190 min,平均(162.4±21.8)min;术中出血量(50～200 ml),平均(129.7±48.3)ml;骨折愈合时间(11～18周),平均(14.1±1.9)周.术后踝关节X线、CT扫描示:14例解剖复位,2例后外侧关节面移位1～2 mm,1例后内侧关节面移位约1 mm;1例术后17个月下地行走时踝周仍有肿胀伴有轻度背伸跖屈受限;1例术后12个月下地行走时踝管处有不适感,尔后症状逐渐消失;1例出现距骨骨软骨损伤;1例出现轻度屈长肌挛缩,其余患者功能恢复良好.末次随访AOFAS踝-后足功能评分平均(89.1±7.5)分,其中优13例,良3例,可1例,优良率94％.VAS评分平均(1.5±1.3)分;踝关节ROM:跖曲平均(35.6±9.5)°,背伸平均(12.8±6.1)°.结论:俯卧位下后内侧改良L形切口能够较好地显露胫骨远端后侧及后内侧骨块,解剖复位率高,接骨板支撑固定牢靠,切口安全,软组织并发症少,是一种安全有效的手术方法.

As one of the most severe kinds of neurological damage, spinal cord injury (SCI) contributes to persistent motor dysfunction and involves a large repertoire of gene alterations. The participation of circular RNAs (circRNAs) in neurological recovery following SCI needs to be clarified. In the current work, we attempted to assess the function of hsa_circRNA_0003962/circTYW1 and its underlying mechanism in SCI. By accessing the GEO repository, the expression of circTYW1, microRNA-380 (miR-380), and FGF9 in SCI and sham-operated rats was evaluated. PC12 cells after oxygen-glucose deprivation (OGD) treatment were prepared to mimic the SCI model. circTYW1 and FGF9 were poorly expressed, whereas miR-380 was highly expressed in the spinal cord tissues of SCI rats. circTYW1 promoted neurological recovery in SCI rats and inhibited apoptosis in spinal cord tissues. In PC12 cells exposed to OGD, circTYW1 suppressed PC12 cell apoptosis; however, miR-380 overexpression reversed the protective effect of circTYW1 on PC12 cells. Also, circTYW1 promoted FGF9 expression through competitively binding to miR-380, which activated the ERK1/2 signaling. In summary, our results demonstrated that declines in circTYW1 prevented SCI rats from neurological recovery by regulating the miR-380/FGF9/ERK1/2 axis, which might provide new understanding for SCI treatment.