The presence of microplastics (MPs) and nanoplastics (NPs) in the human has raised health concerns, yet their tissue-specific accumulation in avascular environments remains unclear. Laser micro-Raman spectroscopy and pyrolysis-gas chromatography/mass spectrometry were employed to quantify MNPs from 21 donors undergoing spinal fusion. MPs showed a tissue-specific abundance gradient, with number concentrations of 6.74 ± 4.40 n/mL in blood, 13.26 ± 5.49 n/g in bone, and 13.55 ± 4.48 n/g in intervertebral disc, and mean particle sizes of 64.50 μm, 57.10 μm, and 77.60 μm, respectively; particles smaller than 100 μm accounted for 90.0%, 92.5%, and 62.5%, respectively. NPs (0.16–20.28 μg/g) were ubiquitously detected, with polyvinyl chloride and polyamide 66, accounting for 78.2% of the total mass, indicating distinct tissue-selective enrichment. A regulated accumulation pattern showed a dominant “disc-enriched” profile in nearly half the individuals. Fiber morphology, white color, larger size, and PET/PE polymers were identified as key drivers of tissue-selective retention. Although calculated chemical risks remain within safety limits, the substantial NPs sequestration in the avascular disc suggests an overlooked mechanism of long-term physical burden and potential tissue degradation. This study provides novel insights into the individualized MNPs accumulation and highlight the need to re-evaluate the health implications of plastic pollution in slow-metabolizing tissues.

Background:Early neurological recovery following acute incomplete cervical spinal cord injury (SCI) is associated with better long-term function. Photobiomodulation (PBM) has shown neuroprotective effects in preclinical studies, but multicenter clinical evidence remains limited. Methods:In this multicenter randomized controlled trial, adults (18-70 years) with American Spinal Injury Association (ASIA) grade C cervical SCI presenting within 24 h were enrolled at three tertiary hospitals and randomized to PBM or control. All patients underwent posterior decompression within 24 h. The PBM group received once-daily PBM for 7 consecutive days (810 nm, 300 mW, 30 min) via a diffusing fiber positioned approximately 1.0 cm above the exposed spinal cord. The control group received standard care without PBM. Co-primary outcomes were change in ASIA motor score and independent ambulation at 3, 6, and 12 months. Secondary outcomes included CSF biomarkers at day 7, SCIM-III, SF-36, EQ-5D, and complications. Results:Of 66 randomized patients, 56 (84.8 %) completed the 12-month follow-up (PBM: n = 25; control: n = 31). PBM patients had significantly higher ASIA motor scores at 0.5 months (mean difference, 8.13; 95 % CI, 5.62 to 10.22; P < 0.001) and 3 months (13.33; 95 % CI, 11.01-15.26; P < 0.001), with no significant between-group difference at 6 or 12 months. The PBM group showed higher-but not statistically significant-independent ambulation rates at 3 and 6 months; rates were similar at 12 months. At day 7, CSF levels of GFAP, Tau, S100β, NSE, and NFH were lower with PBM; exploratory proteomics suggested enrichment of synaptic plasticity and repair-related pathways. Scores on SCIM, SF-36, and EQ-5D favored PBM at 3 and 6 months (all P < 0.001), converging by 12 months. Fewer complications occurred with PBM, and no device-related serious adverse events were observed. Conclusion:Early PBM adjunctive to decompression may improve short-term neurological and functional recovery and reduce CSF markers of neural injury in acute incomplete cervical SCI. The translational potential of this article:Our findings suggest that PBM can be safely integrated into standard decompression surgery and may enhance early recovery, supporting further trials to optimize this approach and translate this adjunctive therapy into clinical practice. Trial registration:Chinese Clinical Trial Registry (ChiCTR2100042296).

Osteoporosis is a major global skeletal disease. Accumulating evidence indicates that microplastics (MPs) may contribute to osteoporosis pathogenesis, although the underlying mechanisms remain unclear. Here, rats were exposed to low‐dose (0.13 mg/kg) or high‐dose (1.3 mg/kg) polystyrene MPs for 4 weeks. MP distribution in femoral heads was visualized using fluorescence microscopy, bone mineral density was measured, and integrated metabolomic‑proteomic profiling was performed, with differential proteins validated via RT‐qPCR.Low‑dose MPs exerted minimal effects on bone metabolism. In contrast, high‑dose MPs induced significant bone loss, suppressed osteoblast function, dysregulated osteoclast‑mediated resorption, and activated specific apoptotic and inflammation-induced senescence pathways not observed in the low‐dose group. Multi‑omics analysis revealed dose‑divergent disruption of lipid, amino acid, and energy metabolism, together with protein alterations associated with redox imbalance and bone remodeling. These results demonstrate a dose‑divergent transition from subclinical metabolic stress to overt osteotoxicity.Notably, the sustained upregulation of Pg 34:1 and quinic acid was identified as a potential metabolic signature of MP‑induced bone damage. Collectively, this study shows that MPs, as hazardous environmental pollutants, can induce osteoporosis via dose‑divergent mechanisms, and provides potential molecular targets and biomarkers for early risk assessment of MP‐associated skeletal disorders.

Microplastics are pervasive environmental pollutants that can enter the human bloodstream, yet their distribution within different parts of the skeleton has not been systematically studied. The skeleton is a highly blood-perfused tissue that undergoes constant remodeling, making it a potential but overlooked site for microplastic accumulation. This study investigated whether local blood flow drives microplastic deposition in bone by analyzing six skeletal sites (skull, finger bones, spine vertebrae, intervertebral discs, ribs, and thigh bone) from eight deceased donors. We used Raman imaging, which identifies chemicals by their light scattering, together with a deep learning model called U-Net and a random forest machine learning algorithm. In parallel, mice were injected with fluorescent microplastics to confirm that particles reach bone through the bloodstream. A data simplification method called Isomap was used to reduce complexity, followed by random forest classification to distinguish microplastics by their skeletal origin and to predict the distribution of environmental samples. We detected microplastics in all sites, with quantities closely linked to local blood supply. The highest concentrations were found in the femur (37.8±25.8 particles per gram) and vertebral body (32.2±12.8), while the skull (22.7±16.0) and the intervertebral disc (26.7±22.5), which has a limited blood supply, had lower levels. Mouse experiments mirrored this perfusion-dependent pattern. The classifier achieved a mean area under the curve (AUC) above 0.85 and successfully forecasted the probable distribution of 80 environmental microplastic samples across bone sites. This study provides the first comprehensive map of microplastic distribution in the human skeleton, demonstrating that blood perfusion is the primary driver of intraskeletal deposition. The predictive framework translates environmental microplastic profiles into site-specific bone exposure estimates, creating a new paradigm for microplastic risk assessment rooted in the bone microenvironment.

The presence of microplastics (MPs) and nanoplastics (NPs) in the human has raised health concerns, yet their tissue-specific accumulation in avascular environments remains unclear. Laser micro-Raman spectroscopy and pyrolysis-gas chromatography/mass spectrometry were employed to quantify MNPs from 21 donors undergoing spinal fusion. MPs showed a tissue-specific abundance gradient (blood: 6.74 ± 4.40 n/mL; bone: 13.55 ± 4.48 n/g; disc: 13.92 ± 4.69 n/g), predominantly composed of polyethylene terephthalate, polyethylene, and polystyrene fragments/fibers (1-100 μm). NPs (0.16-20.28 μg/g) were ubiquitously detected, with polyvinyl chloride and polyamide 66, accounting for 78.2% of the total mass, indicating distinct tissue-selective enrichment. A regulated accumulation pattern showed a dominant “disc-enriched” profile in nearly half the individuals. Fiber morphology, white color, larger size, and PET/PE polymers were identified as key drivers of tissue-selective retention. Although calculated chemical risks remain within safety limits, the substantial NPs sequestration in the avascular disc suggests an overlooked mechanism of long-term physical burden and potential tissue degradation. This study provides novel insights into the individualized MNPs accumulation and highlight the need to re-evaluate the health implications of plastic pollution in slow-metabolizing tissues.

Lumbar intervertebral disc degeneration, a key indicator of aging in the human movement system, is linked to increasing global cases of low back pain. Current diagnostic methods rely on imaging and physician experience, lacking predictive tools and personalized treatment strategies. This study used a multicenter lumbar MRI dataset to map disc degeneration in the Chinese population, revealing three accelerated degeneration phases during the lifecycle. Age heatmaps highlighted the degeneration rate of L1-L3 segments, highly synchronized with true age, serving as a baseline for physiological aging estimation. A contrastive learning-based slice ensemble network achieved a mean absolute error of 2.59 years in age estimation, and multi-center validation confirmed its reliability. Two digital imaging biomarkers, Age Delta and Age Selta, were proposed and preliminarily validated in longitudinal cases as a proof-of-concept demonstration. This study primarily demonstrates the feasibility and potential clinical value of data-driven lumbar aging biomarkers.

Photothermal therapy (PTT) and photodynamic therapy (PDT) represent promising strategies for tumor treatment, as their synergistic effects significantly enhance cancer therapeutic efficacy. In this study, we synthesized compound 111 with second near-infrared region (NIR-II) absorption using terminal branch twisting strategy. Compared to the lead compound 55, 111 exhibits greater distortion with the dihedral angle between the two planes containing the side chains increasing from 31.9 degrees to 48.3 degrees. This structural difference facilitated intersystem crossing, thereby enhancing both photothermal conversion efficiency and singlet oxygen production. Furthermore, the introduction of polyethylene glycol (PEG) branches improves the water solubility and biocompatibility, expanding its potential for in vivo applications. Compared to lead compound, 111 exhibited excellent tumor ablation in vitro and in vivo models. This work provides an important theoretical and practical basis for the development of a new generation of synergistic therapeutic platforms in the NIR-II region.

Microplastics (MPs), pervasive environmental pollutants, have infiltrated human tissues, raising global health concerns. This study investigated the distribution and characteristics of MPs across seven major human organs (lungs, heart, liver, spleen, brain, kidneys, and small intestine) using Raman imaging and machine learning. Tissue samples from eight donors were analyzed for MP presence and characteristics. A deep learning-enhanced U-Net model segmented MPs in Raman images, while a random forest classifier was employed to identify organ-specific MP attribution using 120 imaging features. Animal models supported the systemic distribution of MPs. MPs were ubiquitous across all organs examined. The highest MP abundance was observed in the liver (65.28 ± 23.94 particles/g), small intestine (61.06 ± 25.25 particles/g), and kidneys (58.63 ± 16.50 particles/g). Organ-specific variations in MP characteristics were identified: larger particles dominated the lungs (56.80 ± 57.70 μm), while smaller particles (<10 μm) prevailed in the liver and spleen. Distinct polymer compositions and shape profiles were observed for each organ. The random forest classifier achieved 72.73% accuracy in organ-specific MP attribution. MP abundance was linked to organ vascularity. The findings highlight organ-specific risks of MPs and provide a framework for assessing health impacts, thus guiding targeted interventions to mitigate exposure.

The blood-spinal cord barrier is crucial for preserving homeostasis of the central nervous system. After spinal cord injury, autophagic flux within endothelial cells is disrupted, compromising the integrity of the blood-spinal cord barrier. This disruption facilitates extensive infiltration of inflammatory cells, resulting in exacerbated neuroinflammatory responses, neuronal death, and impaired neuronal regeneration. Previous research has demonstrated that photobiomodulation promotes the regeneration of damaged nerves following spinal cord injury by inhibiting the recruitment of inflammatory cells to the injured site and restoring neuronal mitochondrial function. However, the precise mechanisms by which photobiomodulation regulates neuroinflammation remain incompletely elucidated. In this study, we established a mouse model of spinal cord injury and assessed the effects of photobiomodulation treatment. Photobiomodulation effectively cleared damaged mitochondria from endothelial cells in mice, promoting recovery of hindlimb motor function. Using microvascular endothelial bEnd.3 cells subjected to oxygen-glucose deprivation, we found that the effects of photobiomodulation were mediated through activation of the PINK1/Parkin pathway. Additionally, photobiomodulation reduced mitochondrial oxidative stress levels and increased the expression of tight junction proteins within the blood-spinal cord barrier. Our findings suggest that photobiomodulation activates mitochondrial autophagy in endothelial cells through the PINK1/Parkin pathway, thereby promoting repair of the blood-spinal cord barrier following spinal cord injury.

Intervertebral disc degeneration (IVDD) has emerged as a significant global public health challenge, imposing substantial burdens on both individuals and society. Growing evidence suggests that modulating the mechanical microenvironment and alleviating inflammation in degenerated IVDs can promote tissue regeneration. In this study, we integrated natural pharmaceuticals with tissue engineering strategies to develop functionalized microspheres (GM@mTG-V) through microfluidic synthesis, where vanillin - a natural compound with anti-inflammatory and antioxidant properties - was polymerized with gelatin methacryloyl (GelMA, composed of gelatin derived from methyl acrylamide and methacrylate groups). In vitro, the functionalized microspheres not only enhanced vanillin release efficiency but also effectively suppressed inflammatory responses and oxidative stress in nucleus pulposus (NP) cells. By dynamically regulating matrix stiffness, these microspheres could remodel the mechanical microenvironment of degenerated IVD, significantly promoting extracellular matrix (ECM) secretion. In vivo, both 4 week and 8 week IVDD models demonstrated that GM@mTG-V markedly reduced tissue inflammation, accelerated ECM accumulation, and restored IVD structure, as confirmed by radiographic and histological analyses. This study verifies that GM@mTG-V promotes regeneration of degenerated IVD through dual mechanisms: stabilizing mechanical matrix stiffness and suppressing inflammatory microenvironments, providing a novel and promising therapeutic strategy for early stage IVDD.

Although microplastics have been detected in human blood, placenta and other tissues. In this study, for the first time, we characterized the presence and variation of microplastic deposition patterns in three human skeletal tissues, namely the bone, cartilage, and intervertebral discs. Forty microplastic fragments were observed in 24 samples from the bone, cartilage, and intervertebral disc, ranging from 25.44 to 407.39 μm in diameter. The deposition abundance of microplastics in the human intervertebral disc (61.1 ± 44.2 particles/g) was higher than those in the bone (22.9 ± 15.7 particles/g) and cartilage tissue (26.4 ± 17.6 particles/g). The average sizes of microplastics in intervertebral discs (159.5 ± 103.8 μm) and bone (138.86 ± 105.67 μm) were larger than that in the cartilage tissue (87.5 ± 30.7 μm). The most frequently identified polymers were polypropylene (35 %), ethylene vinyl acetate copolymer (30 %), and polystyrene (20 %). The in vivo experiment suggested that microplastics invaded the bone, cartilage, and intervertebral discs through blood circulation after 4 weeks of exposure. Serum levels of tumor necrosis factor-α (TNF-α), Type Ⅰ procollagen amino-terminal peptide (PINP), and tartrate-resistant acid phosphatase-5b (TRACP-5b) were elevated compared with those in the control group (p < 0.05). Our study suggests that microplastics invade the bone, cartilage, and intervertebral discs through the blood supply, causing distinct patterns of microplastic accumulation in these regions. Microplastic invasion can affect skeletal health by influencing the expression of inflammatory and bone morphogenetic cytokines. These findings provide insights into investigating the impact of microplastics on human skeletal health.

Meniscal injury represents a common type of knee injury, accounting for over 50% of all knee injuries. The clinical diagnosis and treatment of meniscal injury heavily rely on magnetic resonance imaging (MRI). However, accurately diagnosing the meniscus from a comprehensive knee MRI is challenging due to its limited and weak signal, significantly impeding the precise grading of meniscal injuries. In this study, a visual interpretable fine grading (VIFG) diagnosis model has been developed to facilitate intelligent and quantified grading of meniscal injuries. Leveraging a multilevel transfer learning framework, it extracts comprehensive features and incorporates an attributional attention module to precisely locate the injured positions. Moreover, the attention-enhancing feedback module effectively concentrates on and distinguishes regions with similar grades of injury. The proposed method underwent validation on FastMRI_Knee and Xijing_Knee dataset, achieving mean grading accuracies of 0.8631 and 0.8502, surpassing the state-of-the-art grading methods notably in error-prone Grade 1 and Grade 2 cases. Additionally, the visually interpretable heatmaps generated by VIFG provide accurate depictions of actual or potential meniscus injury areas beyond human visual capability. Building upon this, a novel fine grading criterion was introduced for subtypes of meniscal injury, further classifying Grade 2 into 2a, 2b, and 2c, aligning with the anatomical knowledge of meniscal blood supply. It can provide enhanced injury-specific details, facilitating the development of more precise surgical strategies. The efficacy of this subtype classification was evidenced in 20 arthroscopic cases, underscoring the potential enhancement brought by intelligent-assisted diagnosis and treatment for meniscal injuries.

Accurate fine-grained grading of lumbar intervertebral disc (LIVD) degeneration is essential for the diagnosis and treatment design of high-incidence low back pain. However, the grading accuracy is still challenged by lacking the fine-grained degenerative details, which is mainly due to the existing grading methods are easily dominated by the salient nucleus pulposus regions in LIVD, overlooking the inconspicuous degeneration changes of the surrounding structures. In this study, a novel regional feature recalibration network (RFRecNet) is proposed to achieve accurate and reliable LIVD degeneration grading. Detection transformer (DETR) is first utilized to detect all LIVDs and then input to the proposed RFRecNet for the fine-grained grading. To obtain sufficient features from both the salient nucleus pulposus and the surrounding regions, a regional cube-based feature boosting and suppression (RC-FBS) module is designed to adaptively recalibrate the feature extraction and utilization from the various regions in LIVD, and a feature diversification (FD) module is proposed to capture the complementary semantic information from the multi-scale features for the comprehensive fine-grained degeneration grading. Extensive experiments were conducted on a clinically collected dataset, which consists of 500 MR scans with a total of 10225 LIVDs. An average grading accuracy of 90.5%, specificity of 97.5%, sensitivity of 90.8%, and Cohen's kappa correlation coefficient of 0.876 are obtained, which indicate that the proposed framework is promising to provide doctors with reliable and consistent fine-grained quantitative evaluation results of the LIVD degeneration conditions for the optimal surgical plan design.

Both glial cells and glia scar greatly affect the development of spinal cord injury and have become hot spots in research on spinal cord injury treatment. The cellular deposition of dense extracellular matrix proteins such as chondroitin sulfate proteoglycans inside and around the glial scar is known to affect axonal growth and be a major obstacle to autogenous repair. These proteins are thus candidate targets for spinal cord injury therapy. Our previous studies demonstrated that 810 nm photobiomodulation inhibited the formation of chondroitin sulfate proteoglycans after spinal cord injury and greatly improved motor function in model animals. However, the specific mechanism and potential targets involved remain to be clarified. In this study, to investigate the therapeutic effect of photobiomodulation, we established a mouse model of spinal cord injury by T9 clamping and irradiated the injury site at a power density of 50 mW/cm2 for 50 minutes once a day for 7 consecutive days. We found that photobiomodulation greatly restored motor function in mice and downregulated chondroitin sulfate proteoglycan expression in the injured spinal cord. Bioinformatics analysis revealed that photobiomodulation inhibited the expression of proteoglycan-related genes induced by spinal cord injury, and versican, a type of proteoglycan, was one of the most markedly changed molecules. Immunofluorescence staining showed that after spinal cord injury, versican was present in astrocytes in spinal cord tissue. The expression of versican in primary astrocytes cultured in vitro increased after inflammation induction, whereas photobiomodulation inhibited the expression of versican. Furthermore, we found that the increased levels of p-Smad3, p-P38 and p-Erk in inflammatory astrocytes were reduced after photobiomodulation treatment and after delivery of inhibitors including FR 180204, (E)-SIS3, and SB 202190. This suggests that Smad3/Sox9 and MAPK/Sox9 pathways may be involved in the effects of photobiomodulation. In summary, our findings show that photobiomodulation modulates the expression of chondroitin sulfate proteoglycans, and versican is one of the key target molecules of photobiomodulation. MAPK/Sox9 and Smad3/Sox9 pathways may play a role in the effects of photobiomodulation on chondroitin sulfate proteoglycan accumulation after spinal cord injury.

Diseases such as low back pain and disc protrusion, stemming from intervertebral disc degeneration, have emerged as notable global public health challenges. Researchers have dedicated considerable efforts to delaying the onset of intervertebral disc degeneration through timely intervention, thereby fostering the regeneration of degenerative intervertebral discs. In this investigation, an integration of traditional Chinese medicine theory with contemporary research methodologies was undertaken to devise a composite treatment regimen employing varied concentrations of artificial tiger bone powder (JTG) and GelMA gel. The effect of JTG-GelMA hydrogel on the regeneration of degenerative intervertebral discs was scrutinized via both in vitro and in vivo investigations. The results demonstrated that JTG-GelMA hydrogel promotes the regeneration of degenerative intervertebral discs through dual mechanisms of improving the matrix stiffness of NP cells and inhibiting ECM degradation. Furthermore, a positive correlation between the regenerative efficacy and JTG concentration was observed. This research introduces a novel approach for early intervention in intervertebral disc degeneration and furnishes a theoretical framework for the innovative utilization of traditional medicinal formulations.

Microplastics are synthetic solid particles or polymeric matrix composites smaller than five millimeters, potentially being absorbed by various organs and resulting in adverse health effects. Nevertheless, the presence of microplastics in the human skeletal system remains uncertain. In this study, Raman Microspectroscopy was used to detect microplastics within three parts of human skeletal system: bone, cartilage and intervertebral disc. A total of 40 microplastic fragments were observed in twenty-four tissue samples from the skeletal system, making the first such observation. The quantities of microplastics present in intervertebral discs (61.1±44.2 particles/g, average size 159.5±103.8 μm), bone (22.9±15.7 particles/g, average size 138.86±105.67 μm) and cartilage (26.4±17.6 particles/g average size 87.5±30.7 μm) exhibited slight variations. The most frequently identified polymers were polypropylene (PP, 35%), ethylene vinyl acetate copolymer (EVA, 30%) and polystyrene (PS, 20%). These polymers find extensive applications in disposable items, tableware, packaging, clothes, and various other products integral to daily life, such as bottled water consumption and take-out food services. This study has established the prevalence occurrence of microplastics in the human skeletal system for the first time. These findings lay the groundwork for future investigations into the impact of microplastics on human health.

It is a significant task to automatically diagnose knee joint osteoarthritis at a low cost. Using the micro-vibration signal produced by the knee joint during flexion and extension activity should be a valuable implementation approach. In this study, subjects are diagnosed and annotated by expert physicians via knee joint X-ray examination. Then subjects participated in several stand up-squat down-stand up recycles and the vibroarthrographic (VAG) signals of the patella's surface are measured through wearable sensors for diagnosis and grading of Knee disease. In 2-class classification, all subjects are classified into the knee osteoarthritis (KOA) group and the control group (CG). In 3 or 5-class classification, they are classified into several different abnormal groups with increasing heavier symptoms and the control group (CG). Patient features, time domain features, frequency domain features and wavelet features are well combined for auxiliary diagnosis. Several algorithms, XGBoost, LightGBM, CatBoost and Random Forest are used as classifiers. With the proposed feature grouping-crossing method, the accuracy of 2-class, 3-class and 5-class classifications are improved to 90.75%, 73.57% and 47.82%, respectively. The results show that a helpful auxiliary diagnosis framework of knee joint osteoarthritis is obtained through efficient signal acquisition pattern and the good machine learning method. The collection of VAG signals has the advantages of being non-invasively, non-radiation, low-cost and convenient. Based on the proposed method, we can identify and classify early osteoarthritis and the articular cartilage during outpatient clinic visits, which has enormous clinical treatment and health care prevention potential.

BACKGROUND AND OBJECTIVE:Multi-grade osteoarthritis (OA) deterioration monitoring in the daily paradigm using Vibroarthrography (VAG) is very challenging due to two difficulties: (1) the composition of VAG signals is complex in the daily paradigm where friction is intensified because of weight-bearing movements. (2) VAG signal samples near the decision boundary of adjacent deterioration grades are easy to be misclassified. The majority of existing works only focus on the binary classification of OA, providing inadequate assistance in instructing physicians to develop treatment plans based on the presence or absence of OA. Thus, we propose a novel framework for fine-grained multi-grade OA deterioration monitoring in the daily paradigm. METHODS:We propose an end-to-end deep learning framework termed Fine-grained Multi-grade OA Deterioration Monitor (FMOADM), which consists of Multiscale-temporal Feature Extraction (MTFE) and Confusion-Free Master-Slave (CF-MS) Classification. Specifically, MTFE is adopted to extract multiscale-temporal discriminative features from the complicated VAG signals. And center loss is introduced by CF-MS to alleviate confusion at the boundary of adjacent deterioration grades in the feature space. Meanwhile, a master-slave structure is proposed for further fine-grained classification, where the master classifier integrates a channel attention mechanism and the slave classifier is designed to update MTFE parameters. As a result, the proposed method ensures fine-grained multi-grade OA monitoring performance via multiscale-temporal discriminative features and boundary confusion alleviation. RESULTS:Experimental results on the VAG-OA dataset demonstrate that our framework outperforms counterpart methods in the daily paradigm. The proposed framework achieved 78% in precision, obtaining an 8% improvement over the state-of-the-art method. CONCLUSION:The proposed framework benefits efficient multi-grade OA deterioration monitoring, empowering physicians to develop treatment plans based on fine-grained monitoring results. It takes knee joint health monitoring in daily activities a step further toward feasible.

Fixed-axis screw and polyaxial screw exposed many disadvantages in the treatment of multiple thoracolumbar fractures. This is the first report on the treatment of multiple thoracolumbar fractures with percutaneous axial monoplanar pedicle screw. Six patients with multiple vertebral fractures were treated with monoplanar pedicle screw implantation and distraction reduction under general anesthesia. The height correction of injured vertebrae, T11-L2 kyphosis angle, Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were measured before and after operation to evaluate the effectiveness of surgical treatment. All patients underwent smooth surgery, with an average operation time of 117.5 minutes and an average intraoperative blood loss of 71.7 ml. All patients were able to walk with the aid of a waist brace on the 3rd postoperative day and discharged on the 4th postoperative day. Low back pain symptoms were significantly relieved after operation. VAS score, ODI dysfunction index, the height correction of injured vertebrae, T11-L2 kyphosis angle and LL were all satisfactorily corrected immediately after surgery, and satisfactory results were maintained at 6 and 12 months after surgery. All patients received minimally invasive removal of internal fixation at the original surgical incision during 12–14 months after surgery, and the injured vertebrae were well reduced without significant height loss of the injured vertebrae. The use of percutaneous monoplanar pedicle screws for the treatment of multiple thoracolumbar fractures is a minimally invasive technique with satisfactory long-term reduction effect.

As a classic noninvasive physiotherapy, photobiomodulation, also known as low-level laser therapy, is widely used for the treatment of many diseases and has anti-inflammatory and tissue repair effects. Photobiomodulation has been shown to promote spinal cord injury repair. In our previous study, we found that810 nm low-level laser therapy reduced the M1 polarization of macrophages and promoted motor function recovery. However, the mechanism underlying this inhibitory effect is not clear. In recent years, transcriptome sequencing analysis has played a critical role in elucidating the progression of diseases. Therefore, in this study, we performed M1 polarization on induced mouse bone marrow macrophages and applied low-level laser therapy. Our sequencing results showed the differential gene expression profile of photobiomodulation regulating macrophage polarization. We analyzed these genes using gene ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses. Networks of protein-protein interactions and competing RNA endogenous networks were constructed. We found that photobiomodulation inhibited STAT3 expression through increasing the expression of miR-330-5p, and that miR-330-5p binding to STAT3 inhibited STAT3 expression. Inducible nitric oxide synthase showed trends in changes similar to the changes in STAT3 expression. Finally, we treated a mouse model of spinal cord injury using photobiomodulation and confirmed that photobiomodulation reduced inducible nitric oxide synthase and STAT3 expression and promoted motor function recovery in spinal cord injury mice. These findings suggest that STAT3 may be a potential target of photobiomodulation, and the miR-330-5p/STAT3 pathway is a possible mechanism by which photobiomodulation has its biological effects.