Purpose To assess the efficiency and safety of a modified bone cement pusher in percutaneous vertebroplasty (PVP) combined with a multi-target negative pressure rotary-cutting technique in puncture biopsy of bone tumors. Methods The biopsy performed with the modified bone cement pusher commonly used in PVP, and a multi-target negative pressure rotary-cutting technique. A total of 120 patients with spinal and pelvic tumors undergoing needle biopsy in our department were recruited and assigned to new biopsy device group (group A, n=60) or and conventional biopsy device group (group B, n=60). The puncture time, positive rate, consistency rate, and dependence rate between group A and B were compared to assess the efficiency and safety of the new device. Results No biopsy-related complications were reported in both groups. The puncture time (39.44±8.885 min vs. 61.61±9.880 min), positive rate (96.67% vs. 61.67%), consistency rate (96.55% vs. 81.8%), and dependence rate (100% vs. 83.33%) were significantly superb in group A compared with those in group B (all P<0.05). Patients in group A did not require repeated biopsies, and sufficient samples were obtained through the needle trajectory in PVP. All patients with a definite diagnosis were managed with appropriate treatments. Conclusions Featuring high safety, positive rate and consistency rate, the new device can be performed to collect sufficient pathological samples from multiple angles. Wide clinical replication can be expected considering its evident diagnostic efficiency for bone tumor.

Many studies have been published on the characteristics of spinal tuberculosis, but not yet on the risk factors for complications after complete debridement. This study aimed to investigate the risk factors of postoperative complications in patients with thoracolumbar spinal tuberculosis (TB) after complete debridement. The clinical data of patients with thoracolumbar spinal TB after complete debridement admitted to General Hospital of Ningxia Medical University from January 2013 to December 2021 were included in this retrospective study. Patients were included if they had complete clinical data and a minimum follow-up duration of 1 year to ensure adequate assessment of postoperative complications. The study cohort was divided into 2 groups, including complication group and non-complication group according to the presence or absence of postoperative complications. The clinical characteristics of thoracolumbar spinal TB patients who developed postoperative complications were evaluated, and risk factors were analyzed by using univariate and binary multivariate logistic regression analysis. A total of 571 patients were included in this study: 92 patients with complications and 479 patients without complications. The results of the univariate analysis and multivariate binary logistic regression analysis showed that preoperative albumin <35 g/L (odds ratio [OR] = 1.855; 95% confidence interval [CI], 1.106-3.111, P = .019), the number of diseased segments ≥3 (OR = 2.072; CI, 1.183-3.629, P = .011), anemia (OR = 1.691; CI, 1.047-2.731, P = .032) and drug resistance (OR = 1.768; CI, 1.011-3.091, P = .046) were independent risk factors for postoperative complications in patients with thoracolumbar spinal TB after complete debridement. Our findings support that the level of preoperative serum albumin, number of diseased segments, anemia, and drug-resistant TB are independent risk factors for postoperative complications in patients with thoracolumbar spinal TB after complete debridement. Therefore, improving preoperative serum albumin level, correcting anemia, actively preventing and monitoring drug-resistance may effectively reduce the risk of postoperative complications in patients with thoracolumbar spinal TB after complete debridement.

BackgroundSpinal tuberculosis (STB) and Brucella spondylitis (BS) are the two most common infectious diseases of the spine. Despite overlapping clinical features, their immunopathological mechanisms remain poorly defined.MethodsWe performed integrated transcriptomic profiling of infected nucleus pulposus tissues from STB and BS patients, combining single-cell RNA sequencing (STB n=3; BS n=3) with bulk RNA sequencing (STB n=7; BS n=5). Single-cell analysis resolved immune heterogeneity and T-cell subset architecture, whereas bulk RNA-seq defined global transcriptional signatures. Cross-platform integration identified concordant differentially expressed genes and shared pathways. AUCell was applied to quantify T-cell functional programmes. Pseudotime trajectory reconstruction, regulon inference, and cell-cell communication analyses were performed to delineate immune circuit differences.ResultsA total of 67,274 high-quality cells were analysed, identifying nine major cell populations, with T cells as a dominant immune component. STB tissues were enriched in inflammatory cells, including monocytes/macrophages, neutrophils, and osteoclasts, whereas BS showed higher proportions of B and T cells. In STB, CD4 T cells were skewed toward IL26-CD4 T, Cytotoxic CD4 T, Proliferating CD4 T, and Treg subsets, while CD8 T cells were enriched in IFNG-AS1-CD8 T and exhaustion-like populations, reflecting sustained IFN-driven activation with proliferative and apoptotic stress. In contrast, BS exhibited expansion of GZMB-CTLs and IFNG-CTLs subsets, consistent with a focused cytotoxic programme with preserved memory features. Integrated single-cell and bulk analyses demonstrated convergence of overlapping genes on TCR, NF-κB, cytokine signalling, and osteoclast differentiation pathways. Functional scoring and pseudotime analysis indicated broader Th1/Th17 activation and progression toward terminal exhaustion in STB, whereas BS T cells maintained intermediate effector–memory states. Regulatory network analysis revealed a STAT1/IRF-dominated interferon axis in STB and an IRF4/EOMES/RFX3-centred effector–memory programme in BS. Cell-cell communication mapping showed an MHC-II-CD4 axis predominating in STB and an MHC-I-CD8 axis in BS. Despite divergent immune circuits, both conditions converged on osteoclast differentiation pathways, suggesting immune–bone metabolic coupling as a shared mechanism of vertebral destruction.ConclusionsSTB and BS exhibit pathogen-specific T-cell immune circuits that converge on a common osteo-immune pathway, providing mechanistic insight and potential targets for host-directed therapy.

Objectives To investigate the pathological diagnostic value of spinal tuberculosis (STB) lesions with different submitting methods and tissue types, provide a reference for accurate submission of STB tissue specimens, and improve the accuracy of pathological diagnosis. Methods The clinical data and intraoperative lesion specimens of 68 STB patients surgically treated in the Department of Orthopedics of General Hospital of Ningxia Medical University from June 2019 to October 2022 were collected and divided into two groups according to the different ways of submitting lesion tissues for examination. In group A, the lesion tissues were submitted for examination separately, including granulation tissues, vertebral lesion bone tissues, and intervertebral discs for pathological examination; in group B, all lesion specimens were mixed and submitted for pathological examination. Group A included 34 cases, 19 males and 15 females, while Group B included 34 cases, 17 males and 17 females. The tissue specimens were routinely decalcified, dehydrated, embedded, sectioned, and stained with hematoxylin-eosin (HE), and the typical and atypical pathological changes of STB were observed under a high-power microscope. Observe the accuracy rate of pathological diagnosis of different lesion tissues in Group A, and carry out comparative analysis within the group; meanwhile, compare and analyze the difference in pathological diagnosis between Group A and B. Ten cases of clinically suspected STB were selected to undergo lesion tissue puncture biopsy, of which 6 cases were male and 4 cases were female, to obtain suspected granulation tissue, vertebral lesion bone tissue, and intervertebral discs for pathological examination, and to compare and analyze the difference between pathological diagnosis of the preoperative puncture specimens and the final diagnosis after operation. Results In Group A, 27 granulation tissues, 34 vertebral lesion bone tissues, and 30 intervertebral discs were sent for examination respectively, and the accuracy of pathologic diagnosis was 59.3%, 44.1%, and 26.7%. Of the 34 STB patients in Group A, 28 were pathologically diagnosed as STB by comprehensive analysis of granulation tissue, vertebral lesion bone tissue, and intervertebral disc, and the overall pathological diagnostic accuracy rate in Group A was 82.4%. The difference between the overall pathological diagnostic accuracy of group A compared with the independent pathological detection rates of granulation tissue, vertebral lesion bone tissue, and intervertebral disc tissue was statistically significant (P < 0.05); The difference in the accuracy of pathological diagnosis between granulation tissue, intervertebral disc tissue and vertebral lesion bone tissue was not statistically significant in group A (P > 0.05); the difference in the rate of pathological diagnosis between granulation tissue and intervertebral disc tissue was statistically significant (P < 0.05). Thirty-four samples were submitted for examination in Group B, and the accuracy rate of pathological diagnosis was 58.8%. The difference between the overall pathological detection rate of Group A and that of Group B was statistically significant (P < 0.05). Ten cases of clinically suspicious STB were selected for lesion tissue puncture biopsy; suspicious granulation tissue, vertebral lesion bone tissue, and intervertebral disc tissue were sent for examination in 9, 10, and 9 pieces, respectively, and the accuracy rates of pathological diagnosis were 44.4%, 60.0%, and 33. 3%, respectively; the comprehensive analysis of mixed lesion tissue supported the diagnosis of STB in 8 out of 10 cases. However, due to the small sample size, these findings should be considered exploratory and warrant validation in larger cohorts. Conclusions The accuracy of pathological diagnosis of STB lesion tissues submitted separately was higher than that of mixed submission, in which the pathological diagnosis rate of granulation tissue and vertebral bone tissue was higher. It will help to improve the accuracy of pathological diagnosis of STB by submitting STB tissue specimens separately and submitting vertebral lesion bone or granulation tissue by preoperative puncture.

ObjectiveTo investigate the biomechanical characteristics and clinical outcomes after lesion debridement at varying degrees of sacroiliac joint destruction, and to assess the role of internal fixation in postoperative stability.Materials and MethodsFinite element analysis: An intact three-dimensional finite element model of the pelvis was established based on CT data from a healthy adult. On this basis, unilateral sacroiliac joint articular surface destruction of 25%, 50%, 75%, and 100% was simulated. For each destruction level, two postoperative models were constructed: debridement alone and debridement combined with internal fixation. Under physiological standing load conditions, pelvic global displacement, relative displacement of the sacroiliac joint surface, and displacement and stress distributions of the sacrum and ilium were comparatively analyzed among different models. Clinical analysis: A retrospective analysis was performed on 20 patients with sacroiliac joint tuberculosis who underwent lesion debridement at our institution between January 2010 and December 2025. Based on preoperative imaging, all patients had mild sacroiliac joint destruction (<1/3 involvement). The patients were divided into a debridement-alone group (n = 10) and debridement combined with internal fixation group (n = 10). Perioperative variables, including operative time, blood loss, and inflammatory markers, were systematically compared between the two groups. Clinical efficacy was evaluated by dynamically assessing changes in visual analogue scale (VAS) pain scores and Majeed functional scores.ResultsFinite element analysis demonstrated that, in the debridement-alone model, overall pelvic displacement, relative displacement across the sacroiliac joint, as well as local bone displacement and stress values increased progressively with the severity of sacroiliac joint destruction. Under mild destruction, changes in these biomechanical parameters were minimal and showed no significant differences compared with the intact model (P > 0.05). However, under moderate-to-severe destruction, all parameters increased significantly (P < 0.05), indicating a marked reduction in both global and local pelvic stability. Following the addition of internal fixation, overall pelvic displacement, local stress, and relative joint displacement were all significantly reduced under moderate-to-severe destruction conditions. Clinical results showed that, in patients with mild bone destruction, there were no significant differences between the debridement-alone group and the debridement combined with internal fixation group in terms of pain relief, functional recovery, or radiographic improvement during follow-up (P > 0.05). Both groups achieved satisfactory clinical outcomes, with no evident recurrence or complications.ConclusionThis study provides an initial biomechanical arithmetic modeling framework and compares its outputs with relevant clinical findings. The degree of sacroiliac joint destruction is closely associated with postoperative pelvic stability. In cases of mild destruction, debridement alone yields satisfactory outcomes, with no additional benefit observed from adjunctive internal fixation. As the severity of destruction increases, pelvic stability progressively declines, and the stabilizing effect of internal fixation becomes increasingly evident.

BackgroundSpinal tuberculosis (STB) and brucellar spondylitis (BS) show substantial overlap in clinical and imaging manifestations, but their local immunopathological programs and corresponding cellular states have not been systematically compared. This study integrated histopathology and single-cell transcriptomics to compare lesion-level differences between STB and BS and to characterize macrophage states associated with the foamy cell reaction.MethodsThis retrospective case-control study included 80 STB cases and 80 BS cases treated between January 2020 and December 2024. H&E-stained lesion tissues from the full surgical cohort were reviewed for comparative histopathology. Fresh lesion nucleus pulposus tissue from six representative cases (STB = 3, BS = 3) underwent scRNA-seq re-analysis with cell-type annotation, myeloid subclustering, functional module scoring, GSVA, and CellChat analysis. Dual immunofluorescence for CD68 paired with CYP27A1, PLIN2, or PPARγ was used as tissue-level validation.The scRNA-seq workflow focused on the monocyte-macrophage lineage to evaluate lipid-remodelled states associated with the foamy cell reaction. Tissue-level immunofluorescence and supplementary statistical summaries were interpreted as orthogonal support for the transcriptomic findings rather than as stand-alone diagnostic criteria.ResultsHistopathological comparison showed that STB and BS were both dominated by chronic inflammation but exhibited distinct lesion patterns. STB was characterized mainly by tuberculous nodules, caseous necrosis, Langhans giant cells, and granulomatous inflammation, whereas BS more often showed plasma cell infiltration, foamy cell reaction, eosinophil infiltration, and fibrotic repair. These between-group differences were statistically significant (P < 0.05 or P < 0.01, as appropriate).scRNA-seq yielded 67,274 high-quality cells and identified nine major cell types. Re-clustering of the Mono_Macrophage_DC lineage identified 15 subclusters, among which Macro4 was relatively enriched in BS. Rather than showing the highest value for every broad foam-cell-related metric, Macro4 was supported by convergent evidence including relative enrichment in BS, coordinated expression of PPARG, APOE, APOC1, PLIN2, and CYP27A1, and higher lipid-droplet-formation and cholesterol-efflux-related programs in BS_Macro4.Dual immunofluorescence showed higher CD68-normalized overlap fractions for CYP27A1, PLIN2, and PPARγ in BS lesion tissues than in STB lesion tissues (P < 0.05). CellChat analysis further suggested that Macro4 contributed relatively more to the HGF-MET signalling context in BS, although these ligand-receptor relationships should be interpreted as transcriptome-inferred candidate interactions.ConclusionsSTB and BS exhibit distinct local immunopathological programs. STB is characterized by a granulomatous-necrotizing inflammatory pattern, whereas BS more often shows a chronic inflammatory and tissue-repair-associated lesion background with a more prominent foamy cell reaction. Macro4 is best interpreted as a BS-associated lipid-remodelled macrophage state supported by convergent histological and transcriptomic evidence. These findings provide a lesion-level cellular framework for further pathological and mechanistic study rather than a validated stand-alone diagnostic cutoff.

Tuberculosis of the lower cervical spine often results in vertebral destruction, kyphotic deformity, and neural compression, substantially impairing patients’ quality of life. Anterior surgical approaches allow direct access to the lesion, enabling thorough debridement and neural decompression. Autologous iliac crest bone grafting is regarded as the preferred material for spinal reconstruction. However, comprehensive evaluations of the systemic efficacy of this surgical modality in managing cervical tuberculosis complicated by kyphosis remain limited. A retrospective review was conducted on 49 patients diagnosed with lower cervical spinal tuberculosis presenting with kyphotic deformity, who were treated at the Affiliated Hospital of Ningxia Medical University from January 2007 to December 2023. All patients underwent a single-stage anterior debrided lesion resection combined with autologous iliac crest structural grafting and short-segment internal fixation, following at least two weeks of standardized anti-tuberculosis therapy preoperatively. Perioperative data—including operative duration and intraoperative blood loss—were recorded. Clinical and radiographic follow-up was maintained for no less than 12 months postoperatively, with assessments including visual analog scale (VAS) for pain, Frankel neurological grading, local Cobb angle, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and graft union status. The mean operative time was 120.8 ± 12.5 min, with intraoperative blood loss averaging 90.6 ± 12.2 mL. The mean follow-up duration was 18.23 ± 4.12 months. At final follow-up, the local Cobb angle improved from −3.87 ± 1.15° preoperatively to 4.63 ± 0.98° (mean correction of 8.50°, P < 0.05). Pain scores decreased significantly from 6.51 ± 1.00 to 1.41 ± 0.91 (P < 0.05). ESR and CRP levels demonstrated significant reductions (P < 0.05). Neurological function, as indicated by Frankel grading, markedly improved postoperatively. The graft fusion rate was 100

Bone is one of the distant metastases in patients with Breast Cancer (BC). However, the mechanism of BC bone metastasis is not fully understood. The aim of this study was to investigate the potential mechanisms linking bone metastasis-related genes and BC.The training set consisted of data from The Cancer Genome Atlas (TCGA)-BC dataset, which included 1,104 breast cancer samples (comprising 50 with bone metastasis and 1,052 without) and 114 adjacent normal samples. Differentially expressed genes (DEGs1) between breast cancer and normal tissues, as well as DEGs2 between breast cancer bone metastatic and non-bone metastatic tissues, were identified. Weighted gene co-expression network analysis (WGCNA) was then applied to screen breast cancer-related module genes. The intersection of these three sets was taken to obtain candidate genes. Diagnostic genes were identified via univariate Cox regression and Least Absolute Shrinkage and Selection Operator (LASSO) analysis to construct a risk model, which was subsequently validated using the Gene Expression Omnibus (GEO) dataset GSE20685 (327 samples, validation set). Furthermore, immune infiltration analysis, mRNA-miRNA-lncRNA regulatory network construction, and drug sensitivity analysis were performed in the training set. Finally, quantitative reverse transcription polymerase chain reaction (qRT-PCR) was conducted on clinical samples for validation.There were 756 DEGs between BC and control samples. A sum of 6 BC-related modules were acquired by WGCNA. After screening, 997 bone metastasis-associated genes and 73 candidate genes were acquired. A total of 6 diagnostic genes, namely ABHD8, ESRRA, DHPS, ISOC2, MRPL34 and OGFR, were obtained to construct the risk model. Results of the immune microenvironment analysis revealed that the high-risk group exhibited lower levels of certain immune cells, such as T cells and CD8+ T cells. Based on the public database,ESRRA was regulated by various miRNAs, such as hsa-miR-185-3p, hsa-miR-2115-5p. Based on the results of molecular docking experiments, a sum of 67 drugs had significant differences in IC50 between two risk subgroups. Transcriptomic data from TCGA indicated that all six diagnostic genes were significantly upregulated in the BC group (p < 0.05). However, qRT-PCR validation showed that ESRRA and OGFR were significantly downregulated in the BC group (p < 0.05), while the expression trends of the remaining four genes were consistent with the transcriptomic data.We explored the diagnostic genes (ABHD8, ESRRA, DHPS, ISOC2, MRPL34, and OGFR) of bone metastasis in BC, providing a reference for disease-related study.

ObjectiveTo characterize the clinical, radiological, and microbiological features of pyogenic spondylitis (PS) and to describe outcomes observed within a severity-stratified real-world management pathway integrating antimicrobial therapy, stabilization, debridement, and fusion according to structural instability and neurological risk.MethodsWe conducted a retrospective observational cohort study of 149 patients with PS treated at Ningxia Medical University General Hospital between January 2015 and December 2023. Patients were retrospectively grouped according to baseline structural severity, neurological status, and the management strategy actually used in routine care: Group A, antimicrobial therapy plus external immobilization (n = 48); Group B, posterior fixation and fusion plus antimicrobial therapy (n = 57); and Group C, posterior fixation with debridement and fusion via posterior and/or anterior approaches plus antimicrobial therapy (n = 44). Clinical characteristics, microbiological findings, inflammatory markers, VAS, ODI, Cobb angle, perioperative variables, complications, and endpoint-defined recovery were analyzed. Principal-component analysis and adjusted response models were prespecified as exploratory analyses.ResultsThe three groups represented distinct severity strata, ranging from structurally stable disease to destructive disease with neurological compromise. Final diagnostic adjudication identified 73 microbiologically confirmed cases, whereas the prespecified patient-level yield analysis was limited to a 66-case interpretable pretreatment subset, within which positivity was lower in Group C than in Groups A and B (40.0% vs 82.4% and 84.2%, respectively; P = 0.001). At the specimen level, 95 bacterial isolate records were summarized, and S. aureus was the predominant isolate (48/95). All groups showed improvement in inflammatory, pain, functional, and radiological measures over follow-up, although the tempo of recovery differed across severity-matched management strata. Exploratory adjusted analyses were directionally consistent with these descriptive patterns but should be interpreted cautiously.ConclusionsIn this retrospective real-world cohort, a severity-stratified management pathway for PS was feasible and showed coherent microbiological, inflammatory, functional, and radiological recovery patterns within each clinical stratum. These findings support pragmatic escalation according to structural instability and neurological risk, but they should not be interpreted as comparative evidence of treatment superiority.

BackgroundThe safety and efficacy of placing pedicle screws within infected vertebral bodies during surgery for acute pyogenic spondylitis remains controversial. The conventional “skip-level” fixation strategy avoids instrumentation at the infected site but may compromise spinal biomechanical stability and alignment. Conversely, fixation that includes the infected vertebrae can provide immediate stability, facilitate deformity correction, and promote bone fusion, although it carries potential risks of infection recurrence and implant failure.ObjectiveTo describe the short-term outcomes of direct pedicle screw fixation in infected vertebrae for acute pyogenic spondylitis, combined with radical debridement and targeted antimicrobial therapy.MethodsA retrospective analysis was conducted on 32 patients with pyogenic spondylitis who underwent surgical treatment between January 2021 and January 2025. All patients had a confirmed etiological diagnosis obtained via microbiological culture or next-generation sequencing (NGS) of surgical specimens and received individualized perioperative anti-infective therapy guided by clinical pharmacists. The surgical protocol included debridement of the infectious focus and posterior pedicle screw fixation incorporating the infected vertebrae, performed via single-stage posterior, single-stage combined anterior-posterior, or staged combined anterior-posterior approaches. Primary outcomes focused on perioperative adverse events, including implant-related complications, infection recurrence, and wound healing. Secondary outcomes assessed clinical efficacy and involved comparisons of Visual Analog Scale (VAS) pain scores, Oswestry Disability Index (ODI), inflammatory markers (erythrocyte sedimentation rate [ESR], C-reactive protein [CRP], and white blood cell count [WBC]), spinal Cobb angle, Frankel neurological grade, and bone fusion rates. Inflammatory markers and Cobb angle were assessed preoperatively and at 1, 3, and 6 months postoperatively; VAS and ODI were assessed preoperatively and at 1, 3, 6, and 12 months postoperatively; and bone fusion was assessed at 6 and 12 months postoperatively. Bone fusion was independently evaluated by two blinded assessors using Bridwell or modified Lenke criteria.ResultsAll 32 patients completed the 12-month follow-up. One osteoporotic patient developed asymptomatic minor screw loosening, and one diabetic patient experienced delayed wound healing that resolved after treatment. No implant failure, infection recurrence, or severe neurological complications occurred. Friedman tests demonstrated significant overall time effects for all dynamic indicators (all P < 0.0001): ESR (χ²(3) = 62.87, W = 0.65), CRP (χ²(3) = 67.22, W = 0.70), WBC (χ²(3) = 37.93, W = 0.40), Cobb angle (χ²(3) = 34.71, W = 0.36), VAS (χ²(4) = 95.90, W = 0.75), and ODI (χ²(4) = 127.02, W = 0.99). By 6 months, inflammatory markers had decreased markedly: ESR from 55.19 ± 31.05 to 6.00 (3.50, 12.25) mm/h; CRP from 34.10 (13.97, 85.15) to 2.12 (0.96, 3.90) mg/L; and WBC from 9.08 (5.75, 11.27) to 5.46 ± 1.01 ×109/L. The Cobb angle improved from 7.94 (6.84, 14.22)° to 8.34 ± 2.43°. At 12 months, VAS improved from 4.00 (4.00, 5.00) to 1.00 (0.75, 1.00), and ODI decreased from 28.72 ± 8.82% to 5.00 (2.25, 8.00)%. Neurological function recovered to Frankel grade E in 93.8% (30/32) of patients. The overall descriptive fusion rate (successful fusion in at least one graft site) was 78.13% at 6 months and 93.75% at 12 months postoperatively.ConclusionsIn this single-arm retrospective study of 32 patients with acute pyogenic spondylitis, direct pedicle screw fixation involving infected vertebrae was performed in conjunction with radical debridement and targeted antimicrobial therapy. At 12 months, patients demonstrated favorable short-term outcomes, including a low incidence of implant-related complications, significant improvements in pain and disability, a high radiographic fusion rate, and no observed infection recurrence. These findings provide preliminary evidence that this comprehensive protocol is a viable strategy for achieving favorable short-term outcomes in selected patients, and may serve as a practical reference for surgeons considering direct instrumentation in infected vertebrae.

BackgroundOsteosarcoma (OS) patients face the challenge of having few effective therapeutic drugs. Solasonine(SS)is an active component of TCM against OS cells. This study aims to identify the key targets of solasonine in treating OS.MethodsIn this study, the transcriptome data and related gene sets were first downloaded from public databases. Subsequently, candidate targets were obtained by intersecting differentially expressed genes (DEGs) with solasonine and OS disease targets. Key targets were then identified through regression analyses, and a prognostic model was constructed. A nomogram was subsequently constructed using the key targets. The functions and immune microenvironment, as well as the structure, regulatory network, and molecular docking of these key targets, were then analyzed. The expression level of the candidate targets in osteosarcoma cells was verified in RT-qPCR experiments, and the effect of solasonine on the malignant biological behavior of osteosarcoma cells was verified.ResultsDEGs, targets corresponding to solasonine, and OS-related disease targets were intersected to obtain 37 candidate targets. Subsequent regression analyses identified 5 key targets (ATP1A1, CLK1, SIGMAR1, PYGM, HSP90B1). It was further demonstrated that the OS prognostic model constructed using these key targets was robust. The constructed nomogram provided an excellent predictive model. Moreover, some pathways, such as cytokine-cytokine receptor interaction, were significantly enriched, and there were 4 significantly different immune cells and 3 significantly different immune checkpoints (P<0.05). Additionally, natural killer cells and activated B cells were significantly positively correlated (cor = 0.68, P < 0.001). The subsequent regulatory network included transcription factors regulating the 5 targets. All key targets showed favorable molecular docking effects with SS. The target genes all exhibited higher expression in osteosarcoma cell lines(P<0.05). Solasonine can inhibit the malignant biological behavior of cell proliferation, migration and invasion.ConclusionIn this study, ATP1A1, CLK1, SIGMAR1, PYGM, and HSP90B1 were identified as key targets of solasonine in the treatment of OS, and they were found to have reference significance for the treatment of OS. SS can be a potential drug for the treatment of osteosarcoma.

Multi-segmental spinal tuberculosis is a severe infectious disease of the spine affecting multiple vertebral bodies, often leading to spinal instability, progressive kyphosis, and irreversible neurological impairment. Its diagnosis and treatment are notably challenging due to the extensive distribution of lesions and severe bone destruction. A retrospective analysis was conducted on 95 patients with multi-segmental spinal tuberculosis involving four or more vertebrae, who were treated at the Department of Orthopedics, General Hospital of Ningxia Medical University, from January 2001 to December 2024. All patients underwent a combined surgical strategy of posterior long-segment pedicle screw fixation followed by anterior radical debridement, decompression, and autologous iliac crest structural bone grafting. Clinical efficacy was systematically evaluated by assessing preoperative and postoperative indicators, including Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), Cobb angle, Visual analog Scale (VAS) for pain, and Oswestry Disability Index (ODI). At 6 months postoperatively, ESR and CRP levels approached normal values and were within the normal range at the final follow-up. The correction rate of the Cobb angle was 48.32

Objectives:To analyze and compare the biomechanical differences and clinical efficacy of artificial vertebral bodies (AVBs) versus traditional titanium mesh cages (TMCs) reconstruction following total en bloc spondylectomy (TES). Materials and Methods:Finite Element Analysis: A finite element model of T12-L5 vertebrae from a healthy adult was utilized to construct two reconstruction models following L2 TES: Group A (AVB) and Group B (TMC). Using ANSYS software, flexion-extension, lateral bending, and axial rotation loading conditions were simulated to comparatively analyze stress distribution at the prosthesis-endplate interface and biomechanical characteristics of the fixation system; Clinical research: This retrospective study included 20 thoracolumbar tumor patients who underwent posterior TES at our institution from January 2014 to October 2024, divided into AVBs (n = 10) and TMCs (n = 10) reconstruction groups. Systematic comparisons were performed for perioperative parameters (operative time, blood loss, hospital stay), with dynamic assessments of preoperative to final follow-up Visual Analog Scale (VAS) pain scores, American Spinal Injury Association (ASIA) neurological classifications, and Karnofsky Performance Status (KPS) scores. Radiographic measurements of vertebral height and angular alignment changes were conducted to comprehensively evaluate reconstruction outcomes. Results:Finite element analysis revealed that the TMC model exhibited significant stress concentration phenomena across all motion modes compared to the AVB model. Specifically, the stress on the L1 inferior endplate was 50.09%, 17.48%, 74.07%, 133.83%, and 87.23% higher during extension, left lateral bending, right lateral bending, left axial rotation, and right axial rotation, respectively. The L3 superior endplate demonstrated similar stress patterns but with smaller magnitudes. In both implant models, peak stresses occurred during extension and axial rotation, followed by lateral bending, with minimal stress observed during flexion. For the posterior fixation system, no significant differences in maximum stress were observed between the two prosthetic configurations; Clinically, Group A demonstrated significantly lower implant subsidence rates (10% vs 70%) and superior outcomes in intervertebral height loss (1.33 ± 0.82 mm vs 12.36 ± 7.79 mm) and angular loss (p < 0.05). No statistically significant differences were identified between groups regarding hospitalization duration, operative time, intraoperative blood loss, VAS scores, KPS scores, or ASIA grade improvements (p > 0.05). Conclusion:Following TES, the AVB demonstrated more uniform stress distribution and superior biomechanical performance compared to the TMC. Additionally, the AVB effectively reduced implant subsidence rates, maintained intervertebral height, corrected kyphotic deformities, and exhibited enhanced biomechanical stability and clinical efficacy.

To evaluate the clinical efficacy of repairing bone defects caused by benign bone tumors using allograft bone combined with calcium phosphate bone powder. A retrospective analysis was conducted on 55 patients (aged 10–61 years, mean 35 ± 13.2) with benign bone tumors treated at our hospital from June 2020 to December 2022. The bone defects in these cases were created after surgical curettage of the tumor lesions, which included common benign tumors such as osteochondroma, giant cell tumor of bone, and enchondroma. Patients were divided into two groups based on bone graft materials: a simple allograft bone group (n = 30) and a combined group using allograft bone with calcium phosphate bone powder (n = 25). Preoperative data, surgical time, intraoperative blood loss, postoperative complications, imaging findings, limb function, and quality of life (KPS scores) were analyzed. All 55 patients were followed for 12–30 months (mean 13.45 ± 5.18). All incisions healed by primary intention without complications such as graft nonunion, fractures, or tumor recurrence. The combined group showed a significantly shorter healing time (t = 4.280, P < 0.05) and higher KPS scores at 6 months postoperatively (X2 = 3.646, P < 0.05) compared to the simple group. However, no significant differences were observed between groups in healing rate, residual bone defects, or limb function at 12 months postoperatively (P > 0.05). Allograft bone combined with calcium phosphate bone powder is superior to allograft bone alone for repairing bone defects following curettage of benign bone tumors, promoting faster healing and better postoperative functional recovery.

ObjectiveTo evaluate the diagnostic performance and clinical utility of targeted next-generation sequencing (tNGS) in primary osteoarticular infections (POI).MethodsEighty-seven patients diagnosed with POI at the Bone Infection Ward of Ningxia Medical University General Hospital between September 2023 and September 2024 were enrolled, including cases of tuberculous osteoarticular infection (35 cases), Brucella-related osteoarticular infection (21 cases), and pyogenic osteoarticular infection (31 cases). Using bacterial culture, Xpert MTB/RIF assay, Brucella agglutination test, and histopathological examination as reference standards, the diagnostic value of tNGS in pathogen identification and resistance gene analysis was systematically evaluated.ResultsAll patients had complete follow-up data. The cohort comprised 87 POI patients (mean age: 55.36 ± 17.24 years; male-to-female ratio: 1.35:1). tNGS demonstrated significantly higher overall sensitivity than conventional bacterial culture (85.0% vs. 31.0%, P < 0.001). For resistance profiling, tNGS identified Mycobacterium tuberculosis complex mutations associated with resistance to isoniazid (2 cases), rifampicin (2 cases), ethambutol (1 case), pyrazinamide (5 cases), and streptomycin (1 case). Additionally, one fluoroquinolone resistance gene and one extended-spectrum β-lactamase (ESBL)-producing pathogen were detected. Notably, one multidrug-resistant (MDR) case harbored mutations conferring resistance to five anti-tuberculosis agents. Receiver operating characteristic (ROC) curve analysis revealed that tNGS exhibited superior diagnostic accuracy for tuberculous osteoarticular infections (AUC = 0.926), Brucella-related osteoarticular infections (AUC = 0.891), and pyogenic osteoarticular infections (AUC = 0.912), outperforming Xpert MTB/RIF (0.814), Brucella agglutination test (0.832), bacterial culture (0.652), and histopathology (0.704) (all P < 0.05).ConclusiontNGS enables simultaneous pathogen identification and resistance gene detection with high efficiency, broad coverage, and accuracy, demonstrating significant advantages in POI diagnosis. This technology holds critical value in guiding optimized antimicrobial therapy and is recommended as a first-line molecular diagnostic tool for POI.

Epidemiological and clinical analyses of Brucellar spondylitis (BS) are crucial for public health authorities to enhance disease surveillance and optimize case management strategies. However, clinical epidemiological research on BS remains limited. This study analyzed the clinical and epidemiological characteristics of hospitalized BS patients at a hospital in Ningxia, aiming to provide evidence to support region-specific strategies for BS prevention and control. We retrospectively collected demographic profiles, epidemiological characteristics, clinical presentations, laboratory/imaging findings, therapeutic regimens, and prognostic outcomes of BS inpatients admitted to the orthopedic department of a hospital in Ningxia from January 2012 to December 2023. A total of 821 patients with BS were included, consisting of 564 males (68.7

Osteosarcoma, a primary malignant bone tumor predominantly affecting children and adolescents, exhibits a dismal prognosis for patients with metastatic or recurrent disease, characterized by low five-year survival rates. This poor outcome is largely attributed to the incomplete understanding of the molecular mechanisms governing osteosarcoma aggressiveness and metastasis, coupled with a paucity of effective early diagnostic biomarkers and targeted therapeutic strategies. Consequently, elucidating the critical molecular events driving osteosarcoma pathogenesis and identifying novel biomarkers are of paramount importance for improving patient outcomes. Prior research has demonstrated aberrant expression of Zinc Finger DHHC-Type Palmitoyltransferase 9 (ZDHHC9) in various malignancies, but its specific function and clinical significance in osteosarcoma remain poorly defined. This study employed a comprehensive approach integrating bioinformatic analyses and experimental validation to investigate the functional role and clinical relevance of ZDHHC9 in osteosarcoma. Bioinformatic analyses (TIMER, GEPIA, TCGA databases) were utilized to examine ZDHHC9 expression across a pan-cancer landscape and its association with survival in osteosarcoma patients. Immunohistochemistry (IHC) and Western blotting were employed to analyze ZDHHC9 expression in clinical osteosarcoma specimens and cell lines. In vitro assays (CCK-8, colony formation, wound healing, Transwell, flow cytometry, and Western blotting) were performed to evaluate the impact of ZDHHC9 on osteosarcoma cell proliferation, migration, and invasion. Proteomic sequencing, molecular docking, and co-immunoprecipitation (Co-IP) experiments were conducted to explore the interaction between ZDHHC9 and KRAS. Western blotting was used to analyze the regulation of Raf1, ERK1/2, and p-ERK1/2 expression by ZDHHC9 and KRAS. Finally, a xenograft model was employed to assess the effect of ZDHHC9 on in vivo tumor growth. Bioinformatic analyses revealed that elevated ZDHHC9 expression correlates with poor prognosis in osteosarcoma. IHC and Western blotting confirmed significantly increased ZDHHC9 expression in osteosarcoma tissues compared to adjacent non-tumorous tissues. Upregulation of ZDHHC9 was significantly associated with elevated Ki67 levels and advanced Enneking stage, suggesting a link to tumor aggressiveness. In vitro studies demonstrated that downregulation of ZDHHC9 suppressed osteosarcoma cell proliferation, migration, and invasion, while promoting apoptosis. Conversely, upregulation of ZDHHC9 elicited opposite effects. Proteomic sequencing revealed that ZDHHC9 knockdown significantly downregulated the expression of proteins associated with the RAS/MAPK signaling pathway. Functional experiments showed that overexpression of KRAS partially abrogated the inhibitory effects of ZDHHC9 knockdown on cell proliferation, migration, and invasion. Molecular docking and Co-IP experiments confirmed a specific interaction between ZDHHC9 and KRAS, leading to activation of the RAS/MAPK signaling pathway. ZDHHC9 promotes osteosarcoma cell proliferation, migration, and invasion by enhancing KRAS-mediated activity of the RAS/MAPK signaling pathway, which promotes cell cycle progression while inhibiting apoptosis. Data are available via ProteomeXchange with identifier PXD066322.

Objective To summarize the clinical efficacy of anterior-only debridement of tuberculous lesions combined with autologous iliac bone grafting, internal fixation, and fusion in the treatment of lower cervical tuberculosis with kyphotic deformity. Methods A retrospective analysis was performed on 49 patients with a confirmed diagnosis of lower cervical tuberculosis complicated by kyphotic deformity who underwent surgical treatment at our institution between January 2007 and December 2023. There were 28 males and 21 females, with ages ranging from 10 to 82 years (mean ± standard deviation, 51.5 ± 16.0 years). All 49 patients presented with varying degrees of neck and shoulder pain and tuberculous toxic symptoms. The lesion involved 2 vertebral bodies in 43 cases, 3 vertebral bodies in 5 cases, and 4 vertebral bodies in 1 case. Preoperatively, all patients received four-drug anti-tuberculosis therapy for 2–4 weeks, which resulted in alleviation of tuberculous toxic symptoms. All patients underwent a single-stage anterior debridement of tuberculous lesions combined with autologous iliac bone grafting, fusion, and titanium plate internal fixation. The operation time and intraoperative blood loss were recorded. Postoperatively, anti-tuberculosis therapy was continued for 6–12 months. During follow-up, the following were evaluated preoperatively and at the final follow-up: improvement in clinical symptoms, bone graft fusion, surgical incision healing, improvement in neurological function (assessed using the Frankel grade), levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), local Cobb angle, Visual Analogue Scale (VAS) scores, and complications. Results All 49 patients successfully underwent the surgery. The operative time ranged from 75 to 150 minutes (101.2 ± 17.4 minutes), and intraoperative blood loss was 60–180 mL (97.8 ± 24.9 mL). The follow-up duration was 12–28 months. At the final follow-up, significant improvements were observed in the local kyphotic Cobb angle, VAS scores, Frankel grades, and levels of CRP and ESR compared with the preoperative values (all P < 0.05). During the follow-up period, no loosening, displacement, or breakage of internal fixation occurred, all surgical incisions achieved primary healing, and there was no recurrence or sinus formation. Postoperative clinical symptoms were significantly alleviated, and complete bone graft fusion was achieved in all patients, with a fusion time of 3–6 months. Conclusion Single-stage anterior debridement of tuberculous lesions combined with autologous iliac bone grafting, fusion, and titanium plate internal fixation is effective in treating lower cervical tuberculosis with kyphotic deformity, as it can thoroughly eradicate tuberculous foci, restore cervical spinal physiological curvature, reconstruct cervical stability, and achieve favorable clinical outcomes.