Existing annulus fibrosus (AF) repair strategies largely restore structural continuity without reconstructing native collagen heterogeneity, due to limited control over annulus fibrosus cell (AFCs) phenotypes. Here, we hypothesize that fiber density-mediated mechanical cues can directionally regulate AFCs collagen specification. Three‑dimensional electrospun poly(lactic acid)/gelatin fibrous scaffolds with identical composition but distinct fiber densities were fabricated to generate low‑density (LDS) and high‑density (HDS) scaffolds. Fiber density exerted a decisive influence on AFCs phenotype through differential mechanotransduction. LDS was associated with increased collagen type I and α-smooth muscle actin expression, together with elevated RhoA-ROCK-related gene expression and enhanced ERK/AKT phosphorylation, consistent with a fibroblastic phenotype. In contrast, HDS favored collagen type II (COL-II) and aggrecan expression and was associated with increased Piezo1 expression; pharmacological inhibition of Piezo1-related mechanosensing attenuated HDS-associated COL-II expression, supporting its partial contribution to the cartilaginous-like phenotype. Subcutaneous implantation in rats further demonstrated fiber density-dependent differences in host cell infiltration, collagen deposition, and tissue integration in an ectopic environment. Collectively, this study identifies fiber density as an important mechanobiological design parameter for regulating AFCs phenotype and matrix remodeling, providing a structural basis for future AF repair strategies. STATEMENT OF SIGNIFICANCE: Recreating the region-specific collagen heterogeneity of the annulus fibrosus (AF) is a fundamental yet unmet challenge in intervertebral disc regeneration, as this structural hierarchy is essential for anisotropic mechanical function. Current scaffold-based strategies largely fail to provide spatially tunable mechanical cues to direct cell phenotype. This study introduces a biomaterial strategy using three-dimensional scaffolds with programmed low- or high-density fiber microarchitectures. The results showed that low-density scaffolds were associated with a COL-I-enriched phenotype and increased RhoA-ROCK- and MAPK/ERK-related signaling, whereas high-density scaffolds were associated with a COL-II-enriched phenotype and enhanced mechanosensitive Ca²⁺-related signaling. These findings suggest that scaffold fiber density may serve as a useful microarchitectural design parameter for modulating AF cell matrix phenotypes. This study provides a reference for the future design of spatially organized scaffolds aimed at supporting heterogeneous collagen matrix reconstruction in AF repair.

Abnormal mechanical stimulation drives fibrotic scar formation in active wounds by sustaining mechanotransduction, promoting apoptotic cell accumulation and pro-fibrotic amplification that constrain functional regeneration. To address this challenge, we developed a mechanically adaptive hydrogel patch (Gel/VP) through the integration of an interpenetrating polymer network and CNC@PDA@ZIF8 dynamic nanofillers, in which the interpenetrating network provides structural load-bearing and adaptive deformation, while the nanofillers form a force-induced, reconfigurable dissipative network via hydrogen bonding and π-π interactions, collectively dissipating tensile energy upon pre-stretched application, establishing a reverse mechanical buffer at the wound interface, suppressing sustained Piezo1-YAP activation, restoring macrophage efferocytosis-mediated apoptotic cell clearance, and ultimately limiting fibrotic scar formation. The interpenetrating architecture endows the patch with a tunable elastic window matched to the mechanical environment of skin (elastic modulus of 7-15 kPa with twofold extensibility). Under reverse mechanical buffering, the macrophage phagocytic rate increases from 22.50% to 64.50%, significantly enhancing apoptotic cell clearance. In vivo, the patch achieves near-complete wound closure (>95%) within two weeks, markedly reduces α-SMA+ myofibroblast accumulation, promotes ordered collagen remodeling, and substantially decreases scar formation. Overall, by leveraging material-mediated reverse stress buffering to restore macrophage efferocytosis, this study targets apoptotic cell clearance at an early stage of fibrosis and provides a robust antifibrotic material strategy for the functional regeneration of active wounds. STATEMENT OF SIGNIFICANCE: Abnormal mechanical stretching during wound healing is a key yet underrecognized driver of fibrotic scar formation, and current therapies rarely address this physical cue. Here, we develop a stress-adapted hydrogel patch that forms a "reverse mechanical buffer" under pre-stretch, actively redistributing tensile forces at the wound interface. This buffering suppresses mechanotransduction (Piezo1-YAP signaling) while restoring macrophage-mediated clearance of apoptotic cells. By integrating an interpenetrating polymer network with dynamic nanofillers, the material achieves adaptive energy dissipation and mechanical compatibility with skin. This work establishes a mechanically guided, immunomodulatory approach to limit fibrosis, offering a promising biomaterials strategy for scarless healing and functional tissue regeneration.

Ageing plays a pivotal role in spinal cord (SC)-related disorders, but the impact of ageing on the SC, especially with respect to its material properties, remains poorly understood. Prior investigations have primarily focused on static uniaxial testing, leaving dynamic mechanical assessment significantly unexplored. Addressing this research deficit, this investigation delivers an extensive examination of mechanical and viscoelastic characteristics in aged SC specimens utilizing rat models. Essential measurements encompassing elasticity and viscoelasticity, specifically peak force, moduli, and hysteresis, are documented. This investigation uniquely emphasizes the intricate aspects of aged tissue behavior, including frequency-dependent responses, non-linear properties, and conditioning phenomena. For the first time, this study emphasizes the complex characteristics of aged tissue response, such as frequency dependence, non-linearity, and conditioning effects. Furthermore, the influence of preconditioning and conditioning is examined, revealing regional dependencies. These results highlight the inadequacy of current models that assume isotropic, linear elasticity, and homogeneity in representing the SC. The findings establish fundamental material property data essential for subsequent research comparing normal and pathological SC mechanics, advancing computational modeling capabilities and deepening the comprehension of SC structure-function relationships.

ABSTRACT Objective In radiographically stable adult degenerative scoliosis (ADS), unilateral biportal endoscopic (UBE) decompression alone is effective in alleviating symptoms; however, executing adequate decompression without excessive facetectomy in rotated, tortuous anatomy remains challenging. Intraoperative O‐arm navigation has the potential to enhance procedural accuracy of UBE decompression. This study compared the clinical outcomes and radiological parameters between O‐arm navigation–assisted and conventional fluoroscopy‐guided UBE decompression alone in stable ADS. Methods This single‐center retrospective study included 63 patients with radiographically stable ADS who underwent UBE decompression alone between 2021 and 2023 (navigation, NAV: n = 34; non‐navigation, NON‐NAV: n = 29). This study presents details about patients' demographics, perioperative parameters, and up to 24 months follow‐up outcomes. Primary endpoint was the facet preservation rate (FPR) at 1‐month post‐operation, quantified by CT‐based 3D volumetry. Secondary endpoints included DCSA, lateral recess height/angle, dynamic angulation/slip, patient‐reported outcomes (VAS/ODI), and complications. Data were analyzed using independent t‐tests, Wilcoxon rank‐sum tests, and repeated‐measures ANOVA as appropriate. Results Operative time and length of stay were slightly shorter in NAV but not statistically different; estimated blood loss was comparable. NAV and NON‐NAV groups showed significant improvements in VAS of leg/back pain and ODI at 1 month and last follow‐up, without between‐group differences. DCSA increased substantially in both groups (~200%–250%); but dispersion was smaller in NAV, indicating more uniform decompression. Structural preservation favored NAV (higher residual lamina‐facet volumes). Segmentally, NON‐NAV exhibited greater increases in dynamic angulation (8.5° ± 1.2° vs. 6.2° ± 1.4°, p < 0.001) and early slip (2.8 ± 0.8 vs. 1.8 ± 0.8 mm, p < 0.001), although radiographic instability thresholds were not exceeded. Global sagittal and coronal parameters were largely comparable between groups over time. Conclusion In stable ADS, O‐arm navigation for UBE decompression did not prolong operative time nor increase blood loss, and yielded tighter boundary control of decompression, higher facet preservation, and smaller segmental perturbations, while maintaining equivalent symptomatic improvement. The value of O‐arm navigation lies in enabling precise and sufficient decompression while limiting medial facetectomy within stability‐preserving margins.

Lactate significantly accumulates in intervertebral disc degeneration (IVDD) to promote inflammation storm and nucleus pulposus cells (NPCs) senescence. However, eliminating the lactate efficiently and inhibiting the inflammation storm and NPCs senescence stimulated by lactate remains a challenge. Here, we show a lactate metabolism reprogramming reactor, which converts lactate to the inhibitor of NPCs senescence (alanine) through orthogonal tandem catalysis (OTC) reaction, thereby guiding the lactate metabolism reprogramming. Enzymes and substrates are encapsulated to prepare OTC nanoparticles, which are embedded in hydrogel microspheres to form the reactors. The lactate metabolism reprogramming efficiently performs in vitro and sustainably conducts in vivo to down-regulate lactate to reduce NLRP3 activity and up-regulate alanine to decrease oxidative stress, significantly inhibiting the inflammatory storm and NPCs senescence. The biomechanical function of neo-generated tissues reaches 94% of that of normal tissues, showing clinical potentials in reversing the IVDD.

Micro/nano-topographical cues are potent regulators of cellular behavior and function. However, conventional fabrication techniques (e.g., photolithography, nanoimprinting) rely on complex exogenous processing that often induces surface energy loss and impairs biological signal transduction efficiency. Herein, we report a controllable endogenous topographical construction strategy leveraging strain-induced crystalline phase transition in poly(lactide-glycolide-ε-caprolactone) (PLGCL) to spontaneously engineer surface topography. We demonstrate that anisotropic microgrooves-generated via stretch-induced crystal transformation within a critical dimensional range-exert decisive control over bone marrow stromal cell (BMSC) osteogenic differentiation. Mechanistically, an optimal topographical window was identified wherein groove dimensions promote integrin clustering via contact guidance, driving focal adhesion maturation, actomyosin contraction, RhoA/ROCK pathway activation, and YAP nuclear translocation. This cascade enhances BMSC osteogenic differentiation efficiency. Notably, the engineered topography induced heterogeneity within the stem cell population: the early recruitment driven by SDF-1α synergized with the microgroove mediated osteogenic differentiation in the mid to late stage, while mechanical signals dependent on surface curvature/orientation led to differences in differentiation, thereby contributing to stem cell regulation and bone repair. Concomitantly, the film’s rapid early-phase release gradient of SDF-1α effectively recruits endogenous BMSCs to the defect site, replenishing the stem cell pool for repair. In a rat calvarial cranial defect model, SDF-1α-functionalized films exhibited superior regenerative outcomes. Collectively, this work establishes an endogenous topographical construction paradigm, where stretch-induced microgrooves act as physical-mechanical cues instructing stem cell differentiation. Synergizing with chemical cues, this strategy enables precise, cell-free therapeutic repair, offering a new perspective for designing regenerative materials.

PURPOSE:Chemoresistance remains a key hurdle in osteosarcoma therapy. This study aims to delineate the role and underlying mechanisms of spermidine (SPD) in osteosarcoma chemoresistance. EXPERIMENTAL DESIGN:Using osteosarcoma cell lines and xenografts, we combined flow cytometry, Western blotting, proteomic mass spectrometry, and RNA sequencing to characterize SPD-driven changes in cellular pathways and resistance signatures. We tested whether pharmacologic inhibition of SPD biosynthesis, alone or in combination with standard chemotherapy, improves therapeutic response in vivo. RESULTS:Following chemotherapy, either cisplatin (CDP) or doxorubicin (DOX), apoptotic osteosarcoma cells exhibit an upregulation of ornithine decarboxylase 1 and SPD synthase, key enzymes involved in SPD synthesis, resulting in heightened levels of this polyamine. SPD diminishes the therapeutic efficacy of CDP and DOX in osteosarcoma cells, both in vitro and in vivo. Mechanistically, SPD enhances β-catenin activity, which subsequently upregulates genes associated with cancer stemness and ATP-binding cassette transporters, both of which are implicated in drug resistance. Furthermore, pharmacologic inhibition of SPD synthesis using α-difluoromethylornithine markedly increases the chemosensitivity of osteosarcoma cells to CDP and DOX. CONCLUSIONS:These findings illuminate the critical role of apoptotic cell metabolites in mediating treatment resistance and suggest that targeting SPD may offer a promising therapeutic strategy to augment the effectiveness of chemotherapy in osteosarcoma.

ObjectiveThis study aims to investigate the effect of prior percutaneous endoscopic lumbar discectomy (PELD) surgical experience on the learning curve of the unilateral biportal endoscopy (UBE) technique.MethodsA total of 200 patients undergoing single-segment UBE surgery were enrolled. The procedures were performed by four surgeons, who were divided into two groups based on whether they had prior PELD experience (Group A: with; Group B: without). Proficiency in UBE technique was defined as a surgery time of less than 80 min. The cumulative sum analysis (CUSUM) method was used to analyze each surgeon's learning curve. Clinical efficacy was evaluated using patient-reported outcomes (PROs) after surgery: Modified Macnab, VAS-leg, VAS-back, and ODI scores. Follow-up information was obtained 12 months postoperatively.ResultsThe number of cases required for Group A surgeons to achieve proficiency were 17 and 18, significantly fewer than the 25 and 27 cases for Group B surgeons. No significant differences in clinical outcomes were observed between the two groups. The complication rates for Group A and Group B were 5 and 14, respectively.ConclusionPrior PELD surgical experience facilitates learning the UBE technique. This experience further aids in shortening surgical times, lowering complication rates, and decreasing the need for reoperation.

Percutaneous vertebral augmentation is an effective and commonly surgical treatment for osteoporotic vertebral compression fractures, but the problem of bone cement leakage still cannot be prevented. It has been reported that cement leakage occurs in approximately 20

Hip fractures represent a significant public health issue in an aging society. Early surgical intervention for hip fractures in older adults is associated with fewer complications and higher survival rates, and recent reimbursement incentives in Japan have aimed to encourage surgery within 48 h of injury. However, information on the determinants of delayed surgery, including reimbursement incentives, remains limited. This study aimed to investigate the number of days from admission to surgery and identify factors associated with delayed surgery using data from two acute care hospitals in Japan. We retrospectively analyzed data from 1,209 patients aged ≥ 65 years who underwent hip fracture surgery at two hospitals in Japan between April 2021 and March 2024. Patient- and healthcare system-related factors were compared between patients who underwent surgery within 2 days of admission (E group) and those who underwent surgery at later times (L group). Poisson regression was used to identify independent factors associated with delayed surgery. In total, 56

Excessive intracellular iron accumulation can induce mitochondrial dysfunction, leading to chondrocyte ferroptosis, a key contributor to cartilage damage in osteoarthritis (OA). Here, micelle-microfluidic hydrogel microspheres, featuring keto-enol-thiol bridged nano-sized secondary structures that disintegrate within the intracellular peroxidative environment to reveal β-diketone groups with metal chelation capabilities, are utilized for the in situ removal of reactive iron, thereby facilitating cartilage repair through the restoration of mitochondrial homeostasis. The relevant experiments demonstrate that the microspheres reduce iron influx by downregulating transferrin receptor (TfR1) expression and decrease mitochondrial iron uptake by upregulating mitochondrial outer membrane iron-sulfur cluster protein (CISD1), thus restoring intracellular mitochondrial iron homeostasis. Furthermore, the antioxidant properties of the ketone-thioether segments synergistically mitigate chondrocyte phospholipid peroxidation via Nrf2/SLC7A11/GPX4 axis, inhibiting ferroptosis and slowing OA progression. In summary, this system that in situ sustainably chelates reactive iron via metal coordination exhibits great potential in the minimally invasive treatment of OA and other ferroptosis-mediated diseases.

Severe traumatic bone healing relies on the involvement of growth factors. However, excessive supplementation of growth factors can lead to ectopic ossification and inflammation. In this study, utilizing the neural regulatory mechanism of bone regeneration, we have developed a multifunctional three dimensions (3D) printed scaffold containing both vasoactive intestinal peptide (VIP) and nerve growth factor (NGF) as an effective new method for achieving bone defect regeneration. The scaffold is provided by a controlled biodegradable and biomechanically matched poly(lactide-ethylene glycol-trimethylene carbonate) (PLTG), providing long-term support for the bone healing cycle; Factor loading is provided by peptide fiber-reinforced biomimetic antimicrobial extracellular matrix (ECM) (B-ECM) hydrogels with different release kinetics, the hydrogel guides rapid bone growth and resists bacterial infection at the early stage of healing. Physical and chemical characterization indicates that the scaffold has good structural stability and mechanical properties, providing an ideal 3D microenvironment for bone reconstruction. In the skull defect model, compared to releasing VIP or NGF alone, this drug delivery system can simulate a natural healing cascade of controllable release factors, significantly accelerating nerve/vascular bone regeneration. In conclusion, this study provides a promising strategy for implanting materials to repair bone defects by utilizing neuroregulatory mechanisms during bone regeneration.

BACKGROUND:Ferroptosis of chondrocytes plays a crucial role in the progression of osteoarthritis (OA). This study aimed to explore the role of curcumin (Cur) in interfering with chondrocyte ferroptosis in OA. METHODS:Rat chondrocytes were treated with 10 ng/mL interleukin-1β (IL-1β) for 48 hours to mimic the OA microenvironment. The protective effects of Cur were evaluated in vitro by assessing cell viability and ferroptosis. Molecular docking was performed to validate the structural interaction between Cur and the SIRT5 protein. Co-immunoprecipitation (CO-IP) confirmed the binding relationship between SIRT5 and ACSL4. Additionally, the efficacy of Cur in alleviating OA progression was assessed in an in vivo OA rat model. RESULTS:Cur treatment significantly attenuated IL-1β-induced chondrocyte injury by enhancing cell viability and inhibiting ferroptosis. Cur also markedly reduced global protein lysine succinylation levels. IL-1β suppressed SIRT5 expression, while Cur treatment upregulated SIRT5 expression. The molecular structure of Cur exhibits strong complementarity with the SIRT5 protein, forming a stable complex with high binding affinity. Inhibition of SIRT5 attenuated the protective effects of Cur on chondrocytes and increased ACSL4 succinylation levels. SIRT5 physically interacted with ACSL4, and SIRT5-mediated desuccinylation of ACSL4 repressed its function, thereby mitigating ferroptosis. Cur alleviates OA progression in vivo by inhibiting cartilage destruction, bone erosion, and chondrocyte injury, and by smoothing subchondral bone surfaces. CONCLUSION:Cur protects chondrocytes in vitro by inhibiting ferroptosis and suppresses cartilage degeneration and bone erosion in vivo, demonstrating a chondroprotective role in OA. These effects are mediated through SIRT5-dependent desuccinylation of ACSL4, which regulates ferroptosis pathways.

Current clinical treatments for intervertebral disc (IVD) herniation (e.g., discectomy) often lead to re-herniation, and tissue engineering scaffolds for annulus fibrosus (AF) regeneration remain scarce, particularly those capable of mimicking the multilayered structure of native AF. This study combines electrospinning with gas-foaming technology to fabricate a 3D nanofiber scaffold (3DS) with a hierarchical multilayered structure. Subsequently, fibronectin is employed as a "bridge" to immobilize basic fibroblast growth factor (bFGF) onto 3DS through its inherent gelatin and heparin binding domains, ultimately constructing a 3D bioactive AF scaffold (3DFF). In vitro experiments demonstrate that the 3DFF mimicks the multilayered structure of native AF. Through sustained bFGF release, it enhances extracellular signal-regulated kinase (ERK) phosphorylation and activates the Wnt/β-catenin pathway, thereby promoting cell proliferation, migration, and matrix secretion. In vivo experiments using a rat tail AF defect model show that 3DFF mitigates IVD degeneration and facilitates AF regeneration. In summary, this study develops a bioactive biomimetic multilayered annulus fibrosus scaffold, offering a promising strategy for annulus fibrosus repair following discectomy.

BACKGROUND:Far lateral lumbar disc herniation (FLLDH) is a special type of lumbar disc herniation with high rate of missed diagnosis. Selective nerve root block (SNRB) has special advantages in identifying the responsible nerve root. Percutaneous transforaminal endoscopic discectomy (PTED) is a minimally invasive and effective method to treat FLLDH. However, no report has investigated PTED combined with SNRB to treat FLLDH. AIM:To explore the diagnosis and treatment process, surgical technique and clinical efficacy of PTED combined with SNRB to treat FLLDH. METHODS:This is a multicenter center, retrospective, observational study. Between January 2020 and January 2022, 32 patients were initially diagnosed with FLLDH. All the patients were identified using SNRB to determine the responsible segment and involved nerve roots. Because of poor symptomatic control following SNRB, 2 patients were excluded. 30 patients diagnosed with FFLDH underwent PTED. The clinical characteristics, operative and postoperative outcomes, complication and subsequent follow-up were collected. RESULTS:30 patients who underwent SNRB combined with PTED were followed up. The average visual analogue scale (VAS)-leg score, VAS-back score, Oswestry disability index (ODI) score at the Follow-up (1 day, 1 month, 3 months and last follow-up) were significantly different compared per-operation. According to the modified Macnab efficacy evaluation standard, the satisfaction degree at the last follow-up was excellent (28, 93.33%), good (1, 3.33%), medium (1, 3.33%) and poor (0, 0%). CONCLUSION:SNRB provides an effective method for the definite diagnosis of FLDH and responsible nerve roots. Combination therapy offers several advantages including minimal invasiveness, precision, effectiveness, safety and low recurrence rates.

BACKGROUND:Posterior lumbar interbody fusion has good clinical results, but adjacent segment disease (ASD) affects its long-term efficacy. In patients with L4-5 fusion who were followed up for more than 10 years, the ASD incidence was 33.3%. Magnetic resonance imaging (MRI) is key for ASD diagnosis, but metal artifacts from internal fixation limit its use; therefore, removing the artifacts is crucial for ASD diagnosis and treatment. AIM:To evaluate the value of WARP MRI for patients with lumbar ASD. METHODS:In our hospital, the lumbar spines of patients with ASD were assessed via lumbar MRI, including conventional sequences and sequences for artifacts. A PACS workstation was used for image measurement, analysis, and assessment, which mainly included measurement of the internal fixation implant artifact area, evaluation of the visibility of the anatomical structures surrounding the implant, and diagnostic assessment of ASD in the section. Conventional MRI data sequences and artifacts to sequence the contrast analysis of the MRI data. RESULTS:A total of 30 patients with ASD after lumbar fusion and internal fixation were included in the study; the patients included 13 male and 17 female patients and were aged 66.03 ± 5.83 years. The metal artifact area of the WARP T2-tirm sequence was significantly smaller than that of the conventional STIR sequence [(20.85 ± 6.27) cm² vs (50.56 ± 8.55) cm², P < 0.01]. The WARP T2-tirm sequence was observed around the implants, pedicles, intervertebral foramen, and vertebral bodies, and the conventional STIR sequence clearly displayed nerve roots within the intervertebral foramen. In all 30 patients, all adjacent segments of the WARP T2-tirm sequence could be clearly observed (above Grade 4), whereas it was difficult to observe these segments in the conventional STIR sequence due to the presence of more severe metal artifacts. CONCLUSION:WARP sequences can significantly reduce the artifact area in the sagittal and cross-sectional images of titanium alloy spinal fixation, providing a good imaging reference for the diagnosis of ASD.

During peripheral nerve regeneration, current deoxyribonucleic acid (DNA)-based therapeutic platforms face the challenge of precisely regulating Schwann cells (SCs) fate to sustain their repair phenotype due to their inability to stably and precisely integrate multiple bioactive components. Herein, the strain-promoted azide-alkyne cycloaddition reaction is utilized to integrate the neurotrophic factor mimetic peptide RGI and the laminin-derived peptide IKVAV into DNA monomers. Through DNA sequence self-assembly, a programmable DNA-peptide conjugated hydrogel is constructed for loading bone marrow mesenchymal stem cell-derived exosomes. This programmable hydrogel can rapidly, stably, and precisely integrate various bioactive components into the hydrogel network, thereby enabling sequential modulation of peripheral nerve repair. In vitro, studies show that this hydrogel, through sequential modulation mechanisms, can activate the neuregulin-1 (Nrg1)/ErbB pathway to induce the reprogramming of SCs and promote the recruitment and proliferation of repair SCs. The induced repair SCs promote neuronal axon outgrowth and enhance tube formation in endothelial cells. In vivo, this programmable hydrogel can gelate in situ through intraneural injection in a rat sciatic nerve crush injury model, promoting nerve regeneration and functional recovery. In summary, this work provides an effective and practical strategy for peripheral nerve regeneration.

The simultaneous integration of high elasticity and lubricity-hallmarks of biological tissues-remains a fundamental challenge in synthetic hydrogels due to the intrinsic trade-off between "dehydration-induced" elasticity and "hydration-dependent" lubrication. Herein, inspired by the dynamic architecture of living systems, the construction of "living" biodegradable hydrogel microspheres is reported that reconcile this contradiction through internal nano-reinforcement and external molecular lubrication. Crystalline disc-like Laponite nanosheets are intercalated within GelMA networks, acting as dynamic, spatially confining crosslinkers that inhibit water infiltration and preserve network cohesion. Concurrently, zwitterionic brushes are grafted onto the microsphere surface, forming a robust hydration layer via dynamic charge-dipole interactions to enable long-lasting lubrication. This synergistic design endows the microspheres with tunable elasticity (14-4000 Pa) and adjustable friction coefficients (0.12-0.04), achieving a functional convergence of mechanical resilience and surface lubricity. Experimental evaluations confirm their efficacy in inhibiting excessive mechanical stress-induced calcium ion influx and downstream calcium signaling to prevent chondrocyte damage. This work offers a universal strategy to overcome the elasticity-lubrication paradox in hydrogels, unlocking their potential in biomedical engineering, drug delivery, and soft robotic interfaces.

To compare the clinical outcomes and learning curve characteristics of unilateral biportal endoscopic lumbar interbody fusion (UBE-TLIF) and percutaneous uniportal full-endoscopic transforaminal lumbar interbody fusion (Endo-TLIF) in patients with single-segment lumbar degenerative diseases (LDD). A retrospective study was conducted from January 2022 to July 2023, involving a total of 95 patients with single-segment LDD, who were divided into two groups: the Endo-TLIF group and the UBE-TLIF group. The demographic characteristics, radiographic and clinical outcomes, as well as complications were meticulously recorded and analyzed in both groups. The mean operation time of Endo-TLIF group was 224.08 ± 58.90 min, which was significantly longer than that of UBE-TLIF group (169.93 ± 30.86 min) (P < 0.05). The perspective times were significantly shortened in the UBE-TLIF group compared with the Endo-TLIF group (P < 0.05). The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores showed significant improvement post-operation in both groups (P < 0.05). There were no significant differences in VAS, ODI and modified Macnab criteria during the last follow-up periods (P > 0.05). Both groups exhibited similar complication rates and fusion rates (P > 0.05). CUSUM analysis indicated that the stabilization of operation time occurred after 23 cases for Endo-TLIF and 19 cases for UBE-TLIF, respectively. The safety and efficacy of both Endo-TLIF and UBE-TLIF for the treatment of LDD have been demonstrated. As the number of surgeries increased, the operation time for both procedures decreased. Specifically, after 23 surgeries, the operation time for Endo-TLIF reached a relative stability, while for UBE-TLIF it was achieved after 19 surgeries.