Objective:To summarize 10-year orthopedic experiences in the management of hemophilic pseudotumor and to discuss an individualized treatment strategy centered on surgery. Methods:The clinical data of 8 patients with hemophilic pseudotumor between June 2015 and May 2025 were retrospectively analyzed. All patients were male, aged 15-37 years, with a mean age of 27.3 years. Seven patients had hemophilia type A and 1 had hemophilia type B; all had severe hemophilia and no detectable inhibitor. The disease duration ranged from 2 months to 12 years, with a mean of 2.5 years. There were 7 soft-tissue pseudotumors and 1 osseous pseudotumor. Lesions involved the lower leg in 3 cases, the thigh in 1, the hip in 1, both the hip and thigh in 2, and both the knee and thigh in 1. Pseudotumor size ranged from 5 cm×5 cm×4 cm to 32 cm×19 cm×15 cm. Treatment modalities included conservative treatment in 1 case, pseudotumor excision in 5 cases, and transfemoral amputation in 2 cases. Perioperative factor replacement was administered according to hemophilia type and factor activity, followed by wound care, anti-infective treatment when needed, drainage management, and rehabilitation. Results:For 7 patients undergoing surgery, the operation time was 60-120 minutes (mean, 88.6 minutes), and the intraoperative blood loss was 150-700 mL (mean, 342.9 mL). Six patients received coagulation factor Ⅷ at doses of 25 400-40 000 U (mean, 32 600 U); 1 patient received coagulation factor Ⅸ at a dose of 35 000 U; the length of hospital stay was 15-30 days (mean, 22.1 days). All patients were followed up 2-10 years (mean, 3.9 years.). One patient developed a superficial wound infection, which resolved after sensitive antibiotics and dressing changes. One patient with a lower-leg soft-tissue pseudotumor healed after conservative treatment and had no recurrence. Among the 5 patients treated with pseudotumor excision, 1 patient with an osseous pseudotumor achieved satisfactory wound and bone healing after pseudotumor resection, allogeneic bone grafting, and internal fixation; 3 patients with soft-tissue pseudotumors had no recurrence during follow-up; and 1 patient with a giant hip soft-tissue pseudotumor developed recurrence with ulceration and massive bleeding at 2 years after surgery and eventually died after unsuccessful rescue at another hospital. The 2 patients who underwent amputation achieved wound healing and returned to daily life after prosthetic fitting and rehabilitation. Conclusion:Surgery remains the main treatment for hemophilic pseudotumors that fail conservative treatment or present with progressive enlargement, ulceration and infection, or compression of vital structures. Adequate perioperative factor coverage, precise preoperative imaging, complete excision whenever feasible, and meticulous elimination of dead space are essential to reduce complications and recurrence.

OBJECTIVES:To compare the biomechanical properties of a novel Ti-3Zr-2Sn-3Mo-25Nb β‑titanium alloy and a traditional Ti-6Al-4V titanium alloy pedicle screw-rod fixation system in posterior lumbar interbody fusion (PLIF). METHODS:In vitro mechanical tests were conducted to evaluate the bending, tensile, compressive, and torsional performance of the β-titanium alloy screws, connecting rods, and the assembled screw-rod fixation system. Two PLIF finite element models were constructed to compare the effects of Ti-6Al-4V versus β-titanium screw-rod systems on range of motion (ROM) and stresses in the endplate and implants. RESULTS:In vitro tests showed that the β‑titanium alloy screw exhibited good resistance to bending (455.95±18.66 N) and torsion (9.03±0.20 N·m). The maximum tensile load of the β-titanium rod was 17 647.06±101.89 N, and the β-titanium screw‑rod system showed a maximum compressive load of 417.65±5.09 N and a maximum torque of 25.00±0.70 N·m. Compared with Ti-6Al-4V, the β‑titanium model showed a 2.6%-8.3% increase in ROM, and the peak stresses in the interbody bone graft, cage, and endplate increased by 1.4%-8.5%, 2.2%-9.4%, and 2.2%-10.1%, respectively, whereas the peak stresses at the bone-screw interface and within the screw-rod system decreased by 8.8%-23.7% and 19.0%-33.1%, respectively. CONCLUSIONS:The β‑titanium pedicle screw-rod fixation system exhibits good in vitro mechanical performance to provide stability comparable to the conventional Ti-6Al-4V system while markedly reducing stress concentration within the screw-rod construct, suggesting its great potential for clinical application.

Background:Anterior controllable antedisplacement fusion (ACAF) is widely used for cervical ossification of the posterior longitudinal ligament, but long-term complications, such as adjacent segment degeneration (ASD), pseudarthrosis, cage subsidence, and implant failure, remain nonnegligible. This study aimed to explore the influence of the number of fusion levels (NFL) on these complications through finite element (FE) analysis, providing a biomechanical basis for optimizing surgical strategies for ACAF. Methods:Three FE ACAF models (two-level, three-level, and four-level) were established on the basis of a validated C2-T1 cervical spine model. A hybrid loading protocol with a 75 N follower load and physiological moments was applied to simulate physiological motions. Key parameters, including the range of motion (ROM) of the surgical and adjacent segments, disc stress, facet joint force (FJF), endplate stress, and the plate, screw, and screw-bone interface stresses, were compared among the three models. Results:An increase in the NFL led to significant increases in the ROM, disc stress, and FJF of adjacent segments, with the upper adjacent segment showing more prominent changes than the lower segment. The ROM of the surgical segment gradually increased with increasing NFL, and the fusion space micromotion correspondingly increased. Endplate stress and implant-related stresses (plate, screw, and screw-bone interface stresses) all tended to increase steadily with increasing NFL, reflecting a continuous increase in the mechanical load at the surgical site and in the adjacent segments. Conclusions:The NFL is a potential risk factor for long-term complications of ACAF. An increase in the NFL raises the mechanical load in the surgical and adjacent segments, thereby potentially increasing the risks of ASD, pseudarthrosis, cage subsidence, and implant failure.

Osteoarthritis (OA) is a common degenerative joint disease characterized by cartilage degradation and abnormal bone remodeling. Discoidin Domain Receptor 2 (DDR2) has emerged as a critical mediator of OA pathogenesis by disrupting extracellular matrix (ECM) homeostasis. This study investigates the therapeutic potential of DDR2 inhibition via selective allosteric inhibitor WRG-28. To evaluate its in vivo efficacy, an OA rat model was established, followed by intra-articular injections of WRG-28. The therapeutic effects were assessed using μCT, Safranin O/Fast Green staining, immunohistochemistry, and gait analysis. Furthermore, primary chondrocytes were stimulated with Type II collagen (Col II) in vitro, followed by immunofluorescence and qPCR to elucidate the underlying molecular mechanisms. Results showed that WRG-28 significantly attenuated osteophyte formation and cartilage degradation in vivo. Treated OA cartilage exhibited preserved Col II content, alongside suppressed DDR2 activation and reduced expression of matrix metalloproteinase 13 (MMP13). Consistent with these findings, in vitro experiments showed that WRG-28 effectively inhibited DDR2 activation in chondrocytes, leading to downregulated MMP expression and restored levels of cartilage matrix-related genes. Additionally, WRG-28 treatment prevented abnormal chondrocyte calcification. In summary, this study concludes that WRG-28 prevents cartilage degradation and inhibits abnormal chondrocyte calcification by targeting DDR2 activation, offering a novel approach to alleviate the progression of OA.

Biomacromolecules based injectable and self-healing hydrogels are promising soft biomaterials with dynamic and reversible features. Yet, it remains a challenge to achieve both high mechanical strength and dynamic behavior. Here, we present a tough dynamic nanocomposite hydrogel (Fe3O4/PDA@OSA-l-Gel) fabricated by incorporating polydopamine coated iron oxide nanoparticles (Fe3O4/PDA NPs) into dynamically crosslinked biomacromolecular networks of oxidized sodium alginate (OSA) and gelatin (Gel) in the presence of borax. The loading of Fe3O4/PDA NPs significantly enhances the mechanical properties of dynamic nanocomposite hydrogel exhibiting excellent injectable and self-healing properties. The synergistic effect of multiple dynamic chemical bonds (e.g., imine bond, borate ester bond) and physical interactions (e.g., electrostatic interaction, hydrogen bond) that enable excellent mechanical properties (3.78 MPa compressive strength, 674.72 J/m3 energy dissipation and 109.1 kJ/m3 toughness). Fe3O4/PDA NPs play the role of killing two birds with one stone, i.e., act as a nano-crosslinker to enhance mechanical properties of the dynamic nanocomposite hydrogel, and as a carrier for sustained protein release. Furthermore, the dynamic nanocomposite hydrogel exhibits good hemocompatibility and cytocompatibility. This work highlights the novel strategy for doping mussel inspired nanoparticles into dynamic hydrogel networks to enhance mechanical properties and sustain protein release.

OBJECTIVE:The Cartesian Optoelectronic Dynamic Anthropometer (CODA) motion analysis system is a new instrument that measures 3-dimensional joint movement. The study aimed to investigate the reliability and validity of the CODA motion analysis system in assessing the cervical range of motion in healthy people. METHODS:A total of 41 healthy participants were included. Movements in 3 planes (flexion and extension, right and left lateral bending, and right and left axial rotation) were measured by using the CODA motion analysis system. The results for flexion-extension and lateral bending movements were compared with those obtained by a standard inclinometer. Intraobserver and interobserver reliability and validity were assessed using the intraclass correlation coefficient (ICC) method. SE of measurement (SEM) and minimal detectable change (MDC) values were also calculated to identify the measurement errors. RESULTS:High interobserver reliability (ICC range, 0.89-0.94) and validity (ICC range, 0.73-0.89) were found for all 3 planes, while the intraobserver reliability (ICC range, 0.76-0.92) was high, except for right lateral bending (ICC, 0.76) and left axial rotation movements (ICC, 0.84). All SEM and MDC values for intraobserver, interobserver, and criterion validity studies were less than 5° and 10°, respectively. Percentage of SEM of ≤10% and percentage of MDC of ≤30% were obtained for all variables. CONCLUSION:The CODA motion analysis system is a highly reliable, noninvasive, easy-to-use, and reproducible 3-dimensional device for measuring cervical range of motion. It demonstrated good reliability for flexion-extension and lateral bending movements.

Storage and transportation of dynamic hydrogel in ambient conditions is challenging. At present, cold-chain management is the most suitable option but it requires substantial infrastructure and energy. Moreover, the raw materials for preparing dynamic hydrogels often require chemical modification and purification, making the process cumbersome and time-consuming. This poses challenges for the practical applications of dynamic hydrogels. Here, we have developed a dynamic micron-sized (DMS) gel powder that can be packed, stored, and transported in a freeze-dried powdered form and can be rehydrated into a dynamic hydrogel. The dynamic hydrogel obtained by rehydrating the DMS gel powder stored under ambient conditions for 7 months can achieve properties similar to the original hydrogel, including stable protein delivery, mechanical properties, injectability, self-healing and remodeling. We propose a novel strategy for preparing a long-term storable DMS gel powder that can maintain properties similar to those of the original hydrogel. Considering the advantages in terms of convenience and commercialization for practical applications in the biomedical fields, this unique ready-to-use DMS gel powder offers a practical, scalable, and simple solution to enable mass production, cold-chain free, and low cost off-the-shelf dynamic hydrogel.

BACKGROUND:Dural arteriovenous fistulas (DAVFs) pose a significant health threat owing to their high misdiagnosis rate. Case reports suggest that DAVFs or related acute events may follow medication use; however, drug-related risk factors remain unclear. In clinical practice, the concomitant use of multiple drugs for therapy is known as "polypharmacy situations," further increasing the risk of drug-induced DAVF. Real-world studies linking medications and DAVF can alert clinicians to their possibilities and contribute to clinical decision-making and patient education. METHOD:This study investigated adverse events spanning a decade from the FAERS database, employing pharmacovigilance analysis to systematically assess the risk of drug-induced DAVF. Furthermore, the clinical characteristics of these drug-related DAVFs, such as demographic information, complications, and outcomes, were characterized. RESULT:This study generated a broad spectrum of drugs associated with DAVFs. A total of 355 DAVF events, involving 161 drugs across 73 categories, were compiled from millions of records. We identified eight classes of drugs for thorough investigation. Pharmacovigilance analysis revealed that tamoxifen, methylprednisolone, betamethasone, prednisone, rebif, ustekinumab, natalizumab, baclofen, dabigatran etexilate, and bupivacaine have the potential to induce DAVFs. Cerebrovascular thrombotic and embolic events emerge as the most prominent co-adverse events of drug-induced DAVFs. Analyses based on drug-disease targets suggested that the regulation of angiogenesis could be a potential mechanism in tamoxifen-induced DAVFs. Apart from medications with gender-specific prescription patterns, most medications exhibit a high risk of DAVF in adult male cohorts. Five patients with drug-related DAVFs experienced severe (fatal) outcomes, with four reports attributed to tamoxifen. CONCLUSION:These findings highlight the diverse range of drugs implicated in the occurrence or progression of DAVF. Drugs such as tamoxifen, corticosteroids, multiple sclerosis medications, and oral anticoagulants require particular attention. Future research should focus on elucidating the underlying mechanisms and risk factors, such as thrombosis, contributing to drug-induced DAVF to inform preventive strategies and optimize patient care.

BackgroundCurrently, some novel rods with lower elastic modulus have the potential as alternatives to traditional titanium alloy rods in lumbar fusion. However, how the elastic modulus of the rod (rod-E) influences the biomechanical performance of lumbar interbody fusion remains unclear. This study aimed to explore the quantitative relationships between rod-E and the biomechanical performance of transforaminal lumbar interbody fusion (TLIF).MethodsThe intact finite element model of L1-S1 was constructed and validated. Then 12 TLIF models with rods of different elastic moduli (ranging from 1 GPa to 110 GPa with an interval of 10 GPa) were developed. The range of motion (ROM) of the fixed segment, mean strain of the bone graft, and maximum von Mises stresses on the cage, endplate, and posterior fixation system models were calculated. Finally, regression analysis was performed to establish functional relationships between rod-E and these indexes.ResultsIncreasing rod-E decreased ROM of the fixed segment, mean strain of the bone grafts, and peak stresses on the cage and endplate, while increasing peak stress on the screw-rod system. When rod-E increased from 1 GPa to 10 GPa, ROM decreased by 10.4%–39.4%. Further increasing rod-E from 10 GPa to 110 GPa resulted in a 9.3%–17.4% reduction in ROM. The peak stresses on the posterior fixation system showed a nonlinear increase as the rod-E increased from 1 GPa to 110 GPa under most loading conditions. The R2 values for all fitting curves ranged from 0.76 to 1.00.ConclusionThe functional relationships between rod-E and the biomechanical properties of TLIF were constructed comprehensively. When the rod-E exceeds 10 GPa, further increases may not significantly improve stability, however, it may increase the risk of fixation failure. Therefore, a rod with an elastic modulus of approximately 10 GPa may provide optimal biomechanical properties for TLIF.

Red fluorescent hydrogels possessing injectable and self-healing properties have widespread potential in biomedical field. It is still a challenge to achieve a biomacromolecules based dynamic hydrogels simultaneously combining with excellent red fluorescence, good mechanical properties, and biocompatibility. Here we firstly exploited hydrophilic inclusion complex of (R-CDs@α-CD) derived from red fluorescent carbon dots (R-CDs) and α-cyclodextrin (α-CD), and then achieved a red fluorescent and dynamic polysaccharide R-CDs@α-CD/CEC-l-OSA hydrogel. The nanocomposite hydrogel can be fabricated through controlling dopant of red fluorescent R-CDs@α-CD into dynamic polymer networks, taking dynamic crosslinked N-carboxyethyl chitosan (CEC) and oxidized sodium alginate (OSA) as an example. The versatile hydrogel simultaneously combines the features of injection, biocompatibility, and augmented mechanical properties and self-healing behavior, especially in rapid self-recovery even after integration. The R-CDs@α-CD uniformly dispersed into dynamic hydrogel played the role of killing two birds with one stone, that is, endowing red fluorescence as a hydrophilic fluorescent substance, and improving mechanical and self-healing properties as a dynamic nano-crosslinker, via providing hydrogen bonds as reversible crosslinkings. The novel red fluorescent and dynamic hydrogel based on polysaccharides hold promise for using as biomaterials in biomedical field.

This study aims to investigate the effect of adipose-derived stem cells (ADSCs) transplantation on progranulin (PGRN) expression and functional recovery in rats with spinal cord injury (SCI). ADSCs were isolated from the inguinal adipose tissue of rats. A SCI model was created, and ADSCs were injected into the injured area. Various techniques were used to assess the effects of ADSCs transplantation, including hematoxylin-eosin staining, Masson staining, immunofluorescence staining, electron microscopy, MRI, and motor function assessment. The potential mechanisms of ADSC transplantation were investigated using gene expression analysis and protein analysis. Finally, the safety of this therapy was evaluated through hematoxylin-eosin staining and indicators of liver and kidney damage in serum. PGRN expression increased in the injured spinal cord, and ADSCs transplantation further enhanced PGRN levels. The group that received ADSCs transplantation showed reduced inflammation, decreased scar formation, increased nerve regeneration, and faster recovery of bladder function. Importantly, motor function significantly improved in the ADSC transplantation group. ADSCs transplantation enhances functional regeneration in SCI by upregulating PGRN expression, reducing inflammation and scar formation, and promoting nerve regeneration and myelin repair. These findings suggest that ADSC transplantation is a potential therapy for SCI.

The impact of antioxidant intake on the prognosis of osteoarthritis (OA) patients remains unclear. The aim of this study was to investigate the relationship between the composite dietary antioxidant index (CDAI) and all-cause mortality in OA patients. A total of 35,590 participants with OA from the National Health and Nutrition Examination Survey (1999-2020) were included in this study. We analysed the associations between the CDAI and the risk of all-cause mortality in OA patients via a multivariate Cox regression model. Restricted cubic spline regression was used to investigate the dose-response associations between the CDAI and mortality. We also conducted stratified analyses and interaction tests to explore underlying effect modification. After multivariable adjustment, each one-unit increase in the CDAI was associated with a 2.1% reduction in the risk of mortality. Compared with those in the low CDAI group, the multivariate-adjusted hazard ratios (HRs) for mortality for patients in the high CDAI group were lower [Model 1 (HR 0.648, 95% CI 0.557-0.754), Model 2 (HR 0.739, 95% CI 0.627-0.871), and Model 3 (HR 0.788, 95% CI 0.661-0.941)]. We observed a negative nonlinear relationship between the CDAI and all-cause mortality (P < 0.05). Stratification analyses and interaction tests confirmed the robustness of the results. We found a negative nonlinear relationship between the CDAI and all-cause mortality in OA patients. A higher CDAI was significantly associated with a lower risk of mortality. These results highlight the potential advantages of monitoring and evaluating the CDAI status in preventing mortality among patients with OA.

Biomacromolecules based injectable and self-healing hydrogels possessing high mechanical properties have widespread potential in biomedical field. However, dynamic features are usually inversely proportional to toughness. It is challenging to simultaneously endow these properties to the dynamic hydrogels. Here, we fabricated an injectable nanocomposite hydrogel (CS-NPs@OSA-l-Gtn) stimultaneously possessing excellent autonomous self-healing performance and high mechanical strength by doping chitosan nanoparticles (CS-NPs) into dynamic polymer networks of oxidized sodium alginate (OSA) and gelatin (Gtn) in the presence of borax. The synergistic effect of the multiple reversible interactions combining dynamic covalent bonds (i.e., imine bond and borate ester bond) and noncovalent interactions (i.e., electrostatic interaction and hydrogen bond) provide effective energy dissipation to endure high fatigue resistance and cyclic loading. The dynamic hydrogel exhibited excellent mechanical properties like maximum 2.43 MPa compressive strength, 493.91 % fracture strain, and 89.54 kJ/m3 toughness. Moreover, the integrated hydrogel after injection and self-healing could withstand 150 successive compressive cycles. Besides, the bovine serum albumin embedded in CS-NPs could be sustainably released from the nanocomposite hydrogel for 12 days. This study proposes a novel strategy to synthesize an injectable and self-healing hydrogel combined with excellent mechanical properties for designing high-strength natural carriers with sustained protein delivery.

Polysaccharide based self-healing and injectable hydrogels with reversible characteristics have widespread potential in protein drug delivery. However, it is a challenge to design the dynamic hydrogel for sequential release of protein drugs. Herein, we developed a novel mussel inspired sequential protein delivery dynamic polysaccharide hydrogel. The nanocomposite hydrogel can be fabricated through doping polydopamine nanoparticles (PDA NPs) into reversible covalent bond (imine bonds) crosslinked polymer networks of oxidized hyaluronic acid (OHA) and carboxymethyl chitosan (CEC), named PDA NPs@OHA-l-CEC. Besides multiple capabilities (i.e., injection, self-healing, and biodegradability), the nanocomposite hydrogel can achieve sustained and sequential protein delivery of vascular endothelial growth factor (VEGF) and bovine serum albumin (BSA). PDA NPs doped in hydrogel matrix serve dual roles, acting as secondary protein release structures and form dynamic non-covalent interactions (i.e., hydrogen bonds) with polysaccharides. Moreover, by adjusting the oxidation degree of OHA, the hydrogels with different crosslinking density could control overall protein release rate. Analysis of different release kinetic models revealed that Fickian diffusion drove rapid VEGF release, while the slower BSA release followed a Super Case II transport mechanism. The novel biocompatible system achieved sequential release of protein drugs has potentials in multi-stage synergistic drug deliver based on dynamic hydrogel.

Introduction: The application prospects of percutaneous endoscopic lumbar discectomy (PELD) as a minimally invasive spinal surgery method in the treatment of lumbar disc herniation are extensive. This study aims to find the optimal entry angle for the trephine at the L4/5 intervertebral space, which causes less lumbar damage and has greater postoperative stability. To achieve this, we conduct a three-dimensional simulated analysis of the degree of damage caused by targeted puncture-based trephine osteotomy on the lumbar spine.Methods: We gathered clinical CT data from patients to construct a lumbar model. This model was used to simulate and analyze the variations in trephine osteotomy volume resulting from targeted punctures at the L4/5 interspace. Furthermore, according to these variations in osteotomy volume, we created Finite Element Analysis (FEA) models specifically for the trephine osteotomy procedure. We then applied mechanical loads to conduct range of motion and von Mises stress analyses on the lumbar motion unit.Results: In percutaneous endoscopic interlaminar discectomy, the smallest osteotomy volume occurred with a 20° entry angle, close to the base of the spinous process. The volume increased at 30° and reached its largest at 40°. In percutaneous transforaminal endoscopic discectomy, the largest osteotomy volume was observed with a 50° entry angle, passing through the facet joints, with smaller volumes at 60° and the smallest at 70°. In FEA, M6 exhibited the most notable biomechanical decline, particularly during posterior extension and right rotation. M2 and M3 showed significant differences primarily in rotation, whereas the differences between M3 and M4 were most evident in posterior extension and right rotation. M5 displayed their highest stress levels primarily in posterior extension, with significant variations observed in right rotation alongside M4.Conclusion: The appropriate selection of entry sites can reduce lumbar damage and increase stability. We suggest employing targeted punctures at a 30° angle for PEID and at a 60° angle for PTED at the L4/5 intervertebral space. Additionally, reducing the degree of facet joint damage is crucial to enhance postoperative stability in lumbar vertebral motion units.

Background There are many classification systems for atlantoaxial dislocation (AAD). Among these systems, the definitions of irreducible AAD remain vague, and its treatments are not unified. Objective To explore the surgical strategies and efficacy for the treatment of os odontoideum (OO) with AAD. Methods The clinical data of 56 OO patients with AAD who underwent surgery from January 2017 to June 2021 were retrospectively analyzed. AAD was classified into four types, Type I and type II were treated with posterior fixation and fusion. Type III received posterior fixation and fusion after irreducible dislocations were converted to reducible dislocations by translateral mass release or transoral release. Type IV required transoral release for conversion into reducible dislocations before posterior fixation and fusion. The operation time, blood loss, and complications were recorded. The preoperative and postoperative neurological function changes were assessed using the Japanese Orthopedic Association (JOA) score. Postoperative fusion status was assessed by X-ray. Results There were 40 cases of type I-II, 14 cases of type III, and two cases of type IV AAD. The operation times of single posterior fixation and fusion, combined translateral mass release and combined transoral release were 130.52 ± 37.12 min, 151.11 ± 16.91 min and 188.57 ± 44.13 min, the blood loss were 162.63 ± 58.27 mL, 235.56 ± 59.94 mL, 414.29 ± 33.91 mL, respectively. One patient with type III died, one with type III underwent revision surgery due to infection, and three patients with type I had further neurological deterioration after operation. fifty-five patients were followed up for 12–24 months. The follow-up results showed that enough decompression was achieved and that fixation and fusion were effective. The JOA score increased from 9.58 ± 1.84 points preoperative to 13.09 ± 2.68 points at 3 months after operation, 14.07 ± 2.83 points at 6 months and 14.25 ± 2.34 at 12 months after operation, all significant differences compared with preoperative results ( P < 0.05). Conclusion OO patients with irreducible AAD can be treated by translateral mass release or transoral release combined with posterior fixation and fusion, while some of those with bony fusion can be treated by transoral release combined with posterior fixation and fusion.

Background: Olfactory ensheathing cells (OECs) serve as a bridge by migrating at the site of spinal cord injury (SCI) to facilitate the repair of the neural structure and neural function. However, OEC migration at the injury site not only faces the complex and disordered internal environment but also is closely associated with the migration ability of OECs. Methods: We extracted OECs from the olfactory bulb of SD rats aged <7 days old. We verified the micro ribonucleic acid (miR)-145a-5p expression level in the gene chip after SCI and OEC transplantation using quantitative reverse transcription (qRT)-polymerase chain reaction (PCR). The possible target gene Plexin-A2 of miR-145a-5p was screened using bioinformatics and was verified using dual-luciferase reporter assay, Western blot, and qRT-PCR. The effect of miR-145a-5p/plexin-A2 on OEC migration ability was verified by wound healing assay, Transwell cell migration assay, and immunohistochemistry. Nerve repair was observed at the injured site of the spinal cord after OEC transplantation using tissue immunofluorescence and magnetic resonance imaging, diffusion tensor imaging, and the Basso-Beattie-Bresnahan locomotor rating scale were further used for imaging and functional evaluation. Results: miR-145a-5p expression in the injured spinal cord tissue after SCI considerably decreased, while Plexin-A2 expression significantly increased. OEC transplantation can reverse miR-145a-5p and Plexin-A2 expression after SCI. miR-145a-5p overexpression enhanced the intrinsic migration ability of OECs. As a target gene of miR-145a-5p, Plexin-A2 hinders OEC migration. OEC transplantation overexpressing miR-145a-5p after SCI can in-crease miR-145a-5p levels in the spinal cord, reduce Plexin-A2 expression in the OECs and the spinal cord tissue, and promote OEC migration and distribution at the injured site. OEC transplantation overexpressing miR-145a-5p can promote the repair of neural morphology and neural function. Conclusions: Our study demonstrated that miR-145a-5p could promote OEC migration by down-regulating the target gene Plexin-A2, and transplantation of miR-145a-5p engineered OECs was beneficial to enhance neural structural and functional recovery in SCI rats.

The proper microenvironment is critical for the storage and transportation of embryonic stem cells (ESCs). To mimic a dynamic 3D microenvironment as it exists in vivo and consider “off-the-shelf” availability reaching the destination, we proposed an alternative approach that allows for facile storage and transportation of stem cells in the form of ESCs-dynamic hydrogel construct (CDHC) under ambient conditions. To form CDHC, mouse embryonic stem cells (mESCs) were in-situ encapsulated within a polysaccharide-based dynamic and self-biodegradable hydrogel. After storing CDHC in a sterile and hermetic environment for 3 days and then transferring to a sealed vessel with fresh medium for another 3 days, the large and compact colonies retained a 90% survival rate and pluripotency. Furthermore, after transporting and arriving at the destination, the encapsulated stem cell could be automatically released from the self-biodegradable hydrogel. After continuous cultivation of 15 generations of retrieved cells, automatically released from the CDHC, the mESCs underwent 3D encapsulation, storage, transportation, release, and continuous long-term subculture; resumed colony forming capacity and pluripotency were revealed by stem cell markers both in protein and mRNA levels. We believe that the dynamic and self-biodegradable hydrogel provides a simple, cost-effective, and valuable tool for storing and transporting “ready-to-use” CDHC under ambient conditions, facilitating “off-the-shelf” availability and widespread applications.