Abstract:BACKGROUND:Effective analgesia after total knee arthroplasty is crucial for rehabilitation,with adductor canal block being a commonly used method.Traditional single-injection local anesthetics provides limited analgesic duration,and continuous catheter infusion exhibits complexity and high cost. OBJECTIVE:To compare the efficacy and safety of a single injection of liposomal bupivacaine versus continuous catheter infusion of ropivacaine hydrochloride for adductor canal block analgesia after total knee arthroplasty. METHODS:Eighty patients undergoing primary unilateral total knee arthroplasty at Gaoyou People's Hospital from March 2024 to February 2025 were randomly assigned to two groups:the liposomal bupivacaine group and the continuous infusion group.The liposomal bupivacaine group received a single adductor canal block injection of 133 mg(10 mL)liposomal bupivacaine mixed with 5 mL of 0.75%ropivacaine hydrochloride postoperatively.The continuous infusion group received an adductor canal block catheter placed near the saphenous nerve,connected to an analgesic pump delivering 0.25%ropivacaine hydrochloride(loading dose:10 mL;infusion rate:6 mL/h).Analgesic efficacy was assessed by comparing pain scores at various time points postoperatively,postoperative analgesia-free duration,morphine rescue consumption,and postoperative walking distance in both groups.Safety was evaluated by monitoring complications.Additionally,procedural time,cost,patient satisfaction,and hospital stay were compared between the two groups. RESULTS AND CONCLUSION:(1)Pain scores at rest and during movement showed no significant differences between liposomal bupivacaine group and continuous infusion group at 6,12,24,48,and 72 hours postoperatively(P>0.05).The postoperative analgesia-free duration was 19 hours in the liposomal bupivacaine group and 22 hours in the continuous infusion group(P>0.05).(2)Within 72 hours postoperatively,the liposomal bupivacaine group required an average of 78.6 morphine rescue treatments,while the continuous infusion group required 80.5,without significant differences(P>0.05).(3)Procedural time was significantly shorter in the liposomal bupivacaine group(6.1±1.4 min)than in the continuous infusion group(20.3±1.2 min,P<0.05).(4)No differences were observed in patient satisfaction,hospital stay,or walking ability(P>0.05).(5)One case of quadriceps paralysis occurred in the continuous infusion group at 6 hours postoperatively but resolved spontaneously without further complications.Each patient in the liposomal bupivacaine group saved 132 RMB in analgesia-related costs.(6)It is concluded that within 72 hours after total knee arthroplasty,single-injection liposomal bupivacaine provided comparable analgesia to continuous ropivacaine infusion in terms of pain scores,postoperative analgesia-free duration,and morphine rescue requirements.Hospital stay,patient satisfaction,and functional recovery were similar.However,single-injection liposomal bupivacaine adductor canal block is more convenient,saves time,and reduces costs.

Abstract:BACKGROUND:Myelination deficits are a core feature of white matter injury in preterm infants.In recent years,human umbilical cord mesenchymal stem cells have been applied in various animal models of brain injury,demonstrating the capacity to promote myelin repair.Elucidating the regulatory mechanisms by which human umbilical cord mesenchymal stem cells enhance neural myelination will contribute to optimizing therapeutic strategies and facilitating clinical translation. OBJECTIVE:To clarify the reparative effect of human umbilical cord mesenchymal stem cells on myelination disorders caused by maturation arrest of the oligodendrocyte lineage in neonatal rats with white matter injury. METHODS:Seventy-two two-day-old Sprague-Dawley rats were randomly divided into a sham-operated group,a white matter injury group,and a human umbilical cord mesenchymal stem cell transplantation group,with twenty-four rats in each group.A neonatal rat white matter injury model was established by a combination of low-dose lipopolysaccharide and hypoxia-ischemia.Fourteen days after modeling,hematoxylin-eosin staining was used to observe pathological changes in white matter.Immunohistochemistry,western blotting,and real-time quantitative polymerase chain reaction were used to detect the positive expression,protein expression,and mRNA expression levels of oligodendrocyte transcription factor 2,glial antigen 2,and myelin basic protein.Twenty-eight days after modeling,Luxol fast blue staining was performed to observe myelin formation,and the Morris water maze test was used to evaluate spatial learning and memory ability. RESULTS AND CONCLUSION:(1)Fourteen days after modeling,hematoxylin-eosin staining showed that a large number of cells in the white matter injury group were degenerated and necrotic,and the arrangement of nerve fibers was disordered;while the cell morphology in the human umbilical cord mesenchymal stem cell transplantation group was close to normal,and the nerve fibers were arranged more neatly.(2)On day 14 after modeling,there was no statistically significant difference in the positive expression,protein,and mRNA levels of oligodendrocyte transcription factor 2 among the groups(P>0.05).Compared with the sham-operated group,the positive expression,protein,and mRNA levels of glial antigen 2 in the white matter injury group were upregulated(P<0.05),while the positive expression,protein,and mRNA levels of myelin basic protein were downregulated(P<0.05).Compared with the white matter injury group,the positive expression,protein,and mRNA levels of glial antigen 2 in the human umbilical cord mesenchymal stem cell transplantation group were downregulated(P<0.05),while the positive expression,protein,and mRNA levels of myelin basic protein were upregulated(P<0.05).(3)On day 28 after modeling,Luxol fast blue staining results showed that compared with the sham-operated group,the white matter injury group had decreased myelin expression(P<0.05).Compared with the white matter injury group,the human umbilical cord mesenchymal stem cell transplantation group had increased myelin expression(P<0.05).(4)On day 28 after modeling,Morris water maze results showed that compared with the sham-operated group,the white matter injury group had prolonged escape latency and decreased platform crossing times(P<0.05).Compared with the white matter injury group,the human umbilical cord mesenchymal stem cell transplantation group had shortened escape latency and increased platform crossing times(P<0.05).There was no statistical difference in average swimming distance between the groups(P>0.05).These results suggest that human umbilical cord mesenchymal stem cells can promote the maturation of oligodendrocytes in neonatal rats with white matter injury,repair myelination disorders,and improve cognitive function.

Abstract:BACKGROUND:Pulmonary fibrosis is a chronic progressive lung disease characterized by abnormal deposition of extracellular matrix,with current therapeutic options remaining limited.Extracellular vesicles derived from mesenchymal stem cells,with their lipid membrane structure,can cross the internal barriers in the body and directly deliver various anti-fibrotic,immunomodulatory factors(such as growth factors,immunomodulatory cytokines,and chemokines),lipids and nucleic acids(mRNAs and miRNAs)and other bioactive substances to target cells in the lungs. OBJECTIVE:To systematically review the core mechanisms of mesenchymal stem cell extracellular vesicles in the treatment of pulmonary fibrosis,summarize and elaborate on how extracellular vesicles directly deliver the bioactive substances they carry to different target cells in the lungs,demonstrating their unique advantages in regulating the pulmonary fibrosis microenvironment,providing a theoretical basis for the future use of mesenchymal stem cell extracellular vesicles in the treatment of pulmonary fibrosis diseases. METHODS:China National Knowledge Infrastructure,PubMed,clinicaltrials.gov,and the Chinese Clinical Trial Registry were searched.English search terms were"mesenchymal stem cells,extracellular vesicles,pulmonary fibrosis,alveolar epithelium,microvascular endothelium,macrophages,neutrophils."A total of 56 articles were finally included for the summary. RESULTS AND CONCLUSION:In alveolar epithelial cells,the process of epithelial-mesenchymal transition is inhibited by regulating signaling pathways such as protein kinase B/glycogen synthase kinase 3β and transforming growth factor β/Smad.The pro-fibrotic signaling network can be blocked by specific miRNAs(such as miR-466f-3p and let-7).In fibroblasts and endothelial cells,miR-21-5p and miR-218/miR-214-3p are used to intervene in the activation of fibroblasts and endothelial-mesenchymal transition,respectively.From a macroscopic perspective,monocytes are reprogrammed,macrophage polarization is regulated,dendritic cell maturation is inhibited,and the Th17/Treg response is balanced,reshaping the immune microenvironment.Furthermore,mesenchymal stem cell extracellular vesicles modified through engineering approaches(targeted peptide modification and drug co-loading)can also enhance the precise targeting of multiple cell subtypes in the lesion area.However,vesicle heterogeneity,large-scale preparation standards,and in vivo dynamic tracing techniques remain key bottlenecks for clinical translation.Future research should integrate single-cell sequencing and spatial multi-omics technologies to deeply explore the underlying mechanisms of mesenchymal stem cell-derived extracellular vesicles in regulating cellular networks and develop novel clinical treatment strategies for pulmonary fibrosis targeting cells.

Abstract:BACKGROUND:Cell transplantation is one of the effective approaches for repairing spinal cord injury.Our research team previously found that transplanted cerebrospinal fluid-contacting neurons can survive and promote motor function recovery in mice with spinal cord injury.However,whether these transplanted cerebrospinal fluid-contacting neurons differentiate into functional neurons and thereby facilitate motor function recovery remains unclear. OBJECTIVE:To investigate whether transplanted cerebrospinal fluid-contacting neurons differentiate into functional neurons in vivo and contribute to motor function recovery after spinal cord injury. METHODS:Primary cells containing cerebrospinal fluid-contacting neurons were isolated from the cervical spinal cord of C57BL/6 mice within 24 hours after birth and cultured in adherent conditions.The cells were transduced with a lentivirus carrying a multimodal imaging fusion gene and selected with puromycin to purify cerebrospinal fluid-contacting neurons.Differentiation was induced using serum-containing medium.Immunofluorescence staining was performed to detect the expression of neuronal marker NeuN and motor neuron marker ChAT after differentiation.Thirty C57BL/6 mice were randomly divided into three groups.The T10 segment spinal cord injury model was established in the transplantation group and PBS group by clamping method,and the sham operation group only opened the lamina.One week after spinal cord injury,the transplantation group received cell transplantation,and the PBS group was injected with an equivalent volume of PBS.At weeks 1,4,and 8 post-transplantation,spinal cord tissues were collected for immunofluorescence to assess ChAT expression.At week 8,the expression of synaptic marker SYN,inhibitory neurotransmitter marker GAD65/67,and excitatory neurotransmitter marker vGLUT1 was further evaluated.Hematoxylin and eosin staining was used to observe spinal cord morphology.Motor function recovery was assessed using Basso Mouse Scale scoring and footprint analysis. RESULTS AND CONCLUSION:(1)Cerebrospinal fluid-contacting neurons exhibited neural stem cell characteristics in vitro and could differentiate into motor neurons.(2)Transplanted cerebrospinal fluid-contacting neurons survived long-term and differentiated into motor neurons in vivo.(3)The proportion of cerebrospinal fluid-contacting neurons differentiating into motor neurons reached the highest level at 8 weeks post-transplantation(P<0.000 1).(4)At 8 weeks post-transplantation,cerebrospinal fluid-contacting neurons co-expressed SYN,GAD65/67,and vGLUT1,indicating synaptic formation between transplanted cerebrospinal fluid-contacting neurons and host neurons.(5)The Basso Mouse Scale scores of the PBS group remained significantly lower than those of the transplantation group(P<0.001).Transplanted mice exhibited more coordinated gait patterns with only minor toe dragging,whereas PBS-treated mice displayed severe hindlimb dragging.(6)Hematoxylin and eosin staining revealed large cavitation areas in the injury site of PBS-treated mice,whereas the cavitation area was significantly reduced in the transplantation group.These findings confirm that transplanted cerebrospinal fluid-contacting neurons can differentiate into motor neurons both in vitro and in vivo,establish synaptic connections,and ultimately improve motor function in spinal cord injury mice.

Abstract:BACKGROUND:Recently,percutaneous minimally invasive pedicle screw fixation systems have become a popular treatment option for thoracolumbar fractures due to ongoing innovation in orthopedic internal fixation devices.Currently,while many studies compare the effectiveness of open pedicle screw fixation through or across the fractured vertebra,fewer studies compare these two methods when using navigation-assisted percutaneous minimally invasive techniques. OBJECTIVE:To compare the clinical efficacy of percutaneous minimally invasive pedicle screw fixation in the treatment of thoracolumbar fracture through and across the injured vertebra. METHODS:A retrospective analysis was performed on 67 patients with single level thoracolumbar fracture without spinal cord nerve injury who were treated in the Department of Spine Surgery,Affiliated Hospital of Yan'an University from October 2021 to June 2023.All of them were treated with percutaneous pedicle screw fixation with the assistance of computer navigation,and were followed up to 6 months after surgery.The injured vertebrae were divided into transinjured vertebrae group(n=35)and cross-injured vertebrae group(n=32)according to whether or not the injured vertebrae were nailed.The general data,perioperative data,anterior vertebral height ratio,Cobb angle,visual analog scale score and Oswestry disability index of injured vertebra were compared before and after treatment between the two groups.Clinical efficacy of minimally invasive percutaneous transvertebral fixation and transvertebral fixation in thoracolumbar fracture patients without spinal cord nerve injury was compared. RESULTS AND CONCLUSION:(1)There was no significant difference in preoperative general data between the two groups(P>0.05),indicating comparability.(2)Intra-group comparison:anterior vertebral height ratio,Cobb angle,visual analog scale score and Oswestry disability index score of the injured vertebra were significantly improved 7 days and 6 months after surgery in both groups(P<0.05).(3)Comparison between groups:The operative time,intraoperative blood loss,incision length,and intraoperative fluoroscopy times in the transinjured vertebrae group were significantly lower than those in the cross-injured vertebrae group,respectively;the differences were statistically significant(P<0.05).However,there was no significant difference in hospitalization days between the two groups(P>0.05).There was no significant difference in anterior vertebral height ratio,Cobb angle,visual analog scale score and Oswestry disability index score between the two groups at 7 days and 6 months after surgery(P>0.05).(4)It is suggested that for patients with single level thoracolumbar fracture without spinal cord nerve injury,minimally invasive percutaneous pedicle screws across injured vertebrae have the advantages of shorter intraoperative time,less bleeding,smaller surgical incision,and low number of fluoroscopies than transinjured vertebrae.In short-and medium-term follow-up,both percutaneous minimally invasive transvertebral fixation and transvertebral fixation can effectively restore and maintain the height of the injured vertebra,correct kyphotic deformity,restore spinal stability and reduce pain,and obtain excellent clinical results.Less invasive transvertebral percutaneous fixation is recommended for patients with thoracolumbar fracture of AO type A with normal body mass index and no spinal nerve injury or posterior ligament complex injury.

Abstract:BACKGROUND:Surgical decision-making for posterior cruciate ligament avulsion fractures is highly dependent on imaging evaluation.Traditional methods rely on subjective interpretation of CT images,which suffer from limitations such as difficulties in quantifying three-dimensional spatial displacement parameters and insufficient precision in assessing rotational angles.Given the advancements in artificial intelligence(AI)technology,there is a need to develop automated,intelligent image recognition software based on AI algorithms. OBJECTIVE:To investigate the intelligent diagnostic capabilities of AI algorithms for posterior cruciate ligament tibial avulsion fractures in 3D CT images and their effectiveness in accurately assessing 3D parameters of fracture fragments. METHODS:Knee CT data from 24 patients with posterior cruciate ligament tibial avulsion fractures who were treated at the Wangjing Hospital of the China Academy of Chinese Medical Sciences between December 1,2022,and August 30,2024,were retrospectively collected.Three-dimensional reconstruction,intelligent fracture point recognition,and simulated reduction were performed using self-developed AI image recognition software.Translational and rotational parameters of the fracture fragments along the X,Y,and Z axes were obtained.The results were compared with those obtained using picture archiving and communication system(PACS system).The consistency of the two methods was assessed using the rank sum test,Bland-Altman analysis,and linear regression model.The coefficient of variation was calculated to assess software stability. RESULTS AND CONCLUSION:(1)No statistically significant differences were observed in fracture fragment displacement(translation/rotation along X/Y/Z axes)between AI and traditional methods(P>0.05).(2)Bland-Altman analysis indicated good consistency between the two methods,with no significant differences(P>0.05).(3)The R² values of the linear regression models for X,Y,and Z axis displacement and angle fitting were all>0.99.(4)The coefficient of variation of the AI software for three repeated fracture point identifications showed that the coefficient of variation was<20%for 21 imaging samples for total fracture identification and<20%for 18 imaging samples for articular surface fracture identification.(5)This indicates that the AI image recognition software can accurately quantify the three-dimensional parameters of posterior cruciate ligament avulsion fracture fragments.Its measurement results are consistent with those of traditional methods and are highly stable.It can assist physicians in determining the degree of displacement and provide accurate data support for preoperative planning.This software has promising application prospects in the treatment of avulsion fractures.Future studies should expand the sample size and validate its impact on surgical outcomes.

Abstract:BACKGROUND:High tibial osteotomy is an effective treatment for certain patients with knee osteoarthritis;however,traditional T-shaped plates have multiple limitations. OBJECTIVE:To compare the biomechanical performance of titanium alloy porous blocks with that of conventional T-shaped plates and bone grafting schemes in high tibial osteotomy using finite element analysis. METHODS:A computer simulation experiment was conducted,performing three-dimensional finite element analysis on a 55-year-old male patient who underwent high tibial osteotomy.Three different implant geometries were constructed:a conventional T-shaped plate high tibial osteotomy model(Model A),a bone graft-augmented high tibial osteotomy model(Model B),and a titanium alloy porous block-augmented high tibial osteotomy model(Model C).These models were used to evaluate the effects of each implant on total displacement and stress distribution under two loading conditions:standing and initial rising from a seated position. RESULTS AND CONCLUSION:(1)Validation results confirmed that the finite element models were effective.(2)In terms of stability,Model C(titanium alloy porous block-augmented high tibial osteotomy)demonstrated the best reduction in total displacement,with maximum displacements under both standing and rising conditions significantly lower than those of the other two models.(3)Stress analysis revealed that Model C's T-shaped plate experienced the lowest stress values:(40.9±36.5)MPa(standing)and(66.1±44.7)MPa(rising),representing reductions of 91.2%and 92.9%,respectively,compared with Model A.Additionally,Model C exhibited significantly lower mean stress at the lateral hinge region than Models A and B,indicating a reduced risk of lateral hinge fracture.Stress distribution at the proximal osteotomy contact surface and hinge region showed that Model C provided more favorable stress stimulation,which may promote bone healing while lowering hinge fracture risk.(4)It is indicated that the titanium alloy porous block not only enhances initial stability at the osteotomy site but,by optimizing stress transmission pathways and offering a biocompatible environment,also addresses shortcomings in mechanical stability and biological integration found in existing plating techniques.These findings suggest promising clinical application potential.

Abstract:BACKGROUND:Current finite element models of the wrist joint predominantly focus on osseous and ligamentous structures,with insufficient incorporation of musculotendinous components,thereby limiting their fidelity and accuracy. OBJECTIVE:To establish a high-fidelity finite element model of the wrist joint,providing a reference for in-depth biomechanical investigations. METHODS:Upper limb CT and MRI data from a 33-year-old healthy male volunteer were imported into Mimics 20.0.Threshold-based selection,region growing,and image segmentation techniques were employed to reconstruct wrist-related bones and soft tissues(including muscles).The model underwent surface optimization,patch generation,and meshing in SolidWorks 2020 and HyperMesh 14.0.Material property assignment and ligament-cartilage contact interfaces were implemented in ABAQUS 6.13 to construct a three-dimensional finite element model of the wrist joint.Stress distribution across wrist structures under axial compression was analyzed. RESULTS AND CONCLUSION:(1)A three-dimensional finite element model encompassing the ulna,radius,distal humerus,carpal bones,metacarpals,pronator teres,pronator quadratus,supinator,lateral muscle group,volar muscle group,dorsal muscle group,interosseous membrane,major ligaments,and cartilage structures was successfully established,comprising 759 191 elements and 245 510 nodes.The stress distribution pattern at the radiocarpal joint under axial compressive loading on the metacarpals was computationally analyzed and compared with cadaveric studies reported in literature,thereby validating the authenticity and effectiveness of the current model.(2)This investigation employed CT and MRI data to simulate and reconstruct comprehensive wrist joint osseous and soft tissue structures through computational methodologies.The model precisely delineates starting point and ending point of the muscle and characterizes contact interactions between forearm musculature and skeletal elements during muscle pathway simulations,ultimately resulting in a more realistic finite element model of the wrist joint.

Abstract:BACKGROUND:Diabetes wound is one of the serious complications of diabetes patients,and its complex pathological mechanism and clinical treatment dilemma is still a major challenge.In recent years,exosomes have become a new focus in the field of diabetes wound research because they play a key role in intercellular communication,immune regulation,and tissue repair. OBJECTIVE:To investigate the research hotspots and evolutionary trends of exosomes in diabetic wound healing. METHODS:A systematic search was conducted in the Web of Science core collection to identify English literature focusing on exosomes in diabetic wound healing and published between the inception of the database and December 31,2024.The annual publication volume was analyzed to track changes over time.Visual analyses using VOSviewer and CiteSpace software were performed on the retrieved literature to examine key aspects such as authors,countries,institutions,journals,and keywords,providing insights into the current research landscape and evolving hot topics in exosomes for diabetic wound healing. RESULTS AND CONCLUSION:From 2014 to 2024,a total of 424 publications on exosome-promoted diabetic wound healing were produced,contributed by 2 883 authors from 46 countries and featured in 199 journals.In the realm of exosome-promoted diabetic wound healing research,China has emerged as the leading contributor,followed closely by the United States.The journals Journal of Nanobiotechnology and Advanced Healthcare Materials have published the highest number of papers and are recognized for their significant influence in the field.Notably,author Chen Zhenbing and Huazhong University of Science and Technology stand out as the most prolific author and institution,respectively.However,the researcher clusters have yet to attain a substantial scale,indicating that future efforts are necessary to enhance team collaboration.Global research focus is primarily concentrated on ten thematic groups,including adipose-derived stem cells,diabetic wounds,diabetic wound healing,wound healing,endoplasmic reticulum stress,microbubbles,collagen,proteomics,and diabetic foot infections.The research hotspots in this field are undergoing a transition from molecular mechanisms to systemic interventions.Future research trends will center on angiogenesis,macrophages,antimicrobial agents and hydrogels.It is essential to integrate multidisciplinary technologies on this basis to achieve more effective precision treatments and optimize management strategies for diabetic wounds.

Abstract:BACKGROUND:The anatomical morphology of the distal femur and proximal tibia has an important influence on the movement of the tibiofemoral joint,and its role in anterior cruciate ligament injury has been well described.However,the research on the anatomical risk factors of posterior cruciate ligament tibial avulsion fracture is still limited,and no unified consensus has been formed. OBJECTIVE:To investigate the anatomical risk factors for posterior cruciate ligament tibial avulsion fracture. METHODS:The medical records of 53 patients who underwent surgical treatment for posterior cruciate ligament tibial avulsion fracture from March 2021 to September 2024 were retrospectively collected as the posterior cruciate ligament avulsion group(32 males and 21 females),and the data of 53 subjects without posterior cruciate ligament injury in the same period were included as the posterior cruciate ligament normal group(24 males and 29 females).The intercondylar notch width,femoral condyle width,intercondylar notch width index,intercondylar notch height,intercondylar notch shape index,intercondylar notch angle,Blumensaat's line inclination angle,medial tibial posterior slope,and lateral tibial posterior slope were measured and calculated in Magnetic Resonance Imaging to analyze the differences in the anatomical data of the two groups.Binary logistic regression analysis was used to determine the independent risk factors and to establish a risk factor model by receiver operating characteristic curve. RESULTS AND CONCLUSION:(1)The intercondylar notch width index,intercondylar notch shape index,intercondylar notch angle,and medial tibial posterior slope of the posterior cruciate ligament tibial avulsion group were smaller than those of the posterior cruciate ligament normal group,and the differences were statistically significant(P<0.05).The data of the two groups were not statistically different in the intercondylar notch width,femoral condyle width,intercondylar notch height,Blumensaat's line inclination angle,and lateral tibial posterior slope(P>0.05).(2)Binary logistic regression found that the intercondylar notch width index was associated with posterior cruciate ligament tibial avulsion fracture.(3)It is indicated that patients with posterior cruciate ligament tibial avulsion fracture had smaller intercondylar notch width index,intercondylar notch shape index,intercondylar notch angle,and medial tibial posterior slope compared with those with a normal posterior cruciate ligament.The intercondylar notch width index was an independent risk factor for tibial avulsion fracture of the posterior cruciate ligament.

Abstract:BACKGROUND:Mesenchymal stem cells have shown good therapeutic effects in ischemic stroke,while the role of multilineage-differentiating stress-enduring(Muse)cells isolated from adipose-derived mesenchymal stem cells in ischemic stroke needs further study. OBJECTIVE:To explore the neurorestorative effect of intravenous administration of adipose Muse cells on ischemic stroke in rats. METHODS:The Muse cells expressing stage-specific embryonic antigen 3 were sorted by magnetic beads after long-term(4 hours)trypsin incubation of human adipose-derived mesenchymal stem cells.The middle cerebral artery occlusion model was established in rats.After successful modeling,the adipose-derived mesenchymal stem cell group and adipose-derived Muse group were injected with 200 μL adipose-derived mesenchymal stem cell suspension or adipose-derived Muse cell suspension(containing 2×105 cells)via the tail vein.The saline group was injected with 200 μL saline.Behavioral scores of rats were evaluated at 3 and 7 days after injection.At 3 days after injection,hematoxylin-eosin staining was used to detect brain tissue damage.Immunofluorescence was used to detect the expression of microtubule-associated protein 2 and Ki67 in the brain tissue injury area.TUNEL staining was used to observe cell apoptosis in the injury area.Western blot assay was used to detect the protein expression of growth-associated protein 43,Bcl2,and Bax. RESULTS AND CONCLUSION:(1)After magnetic bead sorting,the flow cytometry showed that the expression rate of stage-specific embryonic antigen 3 was as high as 80%.(2)At 7 days after injection,the neurological function injury scores of the adipose mesenchymal stem cell group and the adipose Muse cell group were reduced compared with those of the saline group(P<0.05).At 3 days after cell transplantation,the neurological function injury scores of the adipose Muse cell group were reduced compared with those of the adipose mesenchymal stem cell group(P<0.05).(3)Hematoxylin-eosin staining showed that the inflammatory response and vacuolation in the cerebral cortex of rats in the adipose mesenchymal stem cell group and the adipose Muse cell group were alleviated.Microtubule-associated protein 2 fluorescence staining showed that the adipose Muse cell group inhibited neuronal loss more significantly.(4)TUNEL staining and Ki67 fluorescence staining results showed that apoptosis of cells in the injured area of the adipose mesenchymal stem cell group and the adipose Muse cell group was reduced,and cell proliferation was increased.(5)Western blot assay results showed that the Bcl-2/Bax ratio and growth-associated protein 43 protein expression in the adipose mesenchymal stem cell group and the adipose Muse cell group were increased,and the adipose Muse cell group was superior to the adipose mesenchymal stem cell group in inhibiting cell apoptosis.The results showed that the nerves of rats transplanted with adipose mesenchymal stem cells and adipose Muse cells were well repaired,and Muse cells played a better role in inhibiting cell apoptosis.

Abstract:BACKGROUND:Endplate defects are one of the important causative factors of lumbar degeneration,and their morphological characteristics may significantly affect the local mechanical environment of the spine.However,the effects of their different morphologic defects on the biomechanical properties of the lumbar spine have not been fully elucidated. OBJECTIVE:To investigate the effects of focal marginal defects,focal central defects,and angular defects on the stress distribution of lumbar endplates,intervertebral discs,and small joints,and to reveal their underlying biomechanical mechanisms. METHODS:Lumbar CT images were obtained from a healthy 36-year-old male volunteer,and a complete endplate model of the L4-L5 segment was reconstructed.Three typical endplate defect models(focal marginal defect,focal central defect,and angular defect)were constructed based on the classification of vertebral endplate defects in clinical imaging studies.By applying dynamic loads and corresponding moments to simulate physiological spinal muscle loads and typical motion loads,such as stance,forward flexion,backward extension,lateral bending,and rotation,the biomechanical stress distribution characteristics and peak changes in the vertebral cartilage endplates,intervertebral disc annulus fibrosus,nucleus pulposus,and facet joints during physiological spinal motion were evaluated under different defect types.The mechanisms by which different defect types affect lumbar spine biomechanical stability were explored. RESULTS AND CONCLUSION:(1)Different defect types significantly altered the stress conduction pathways in the endplates and adjacent structures.Edge defects primarily affected the stress distribution on the lateral side of the annulus fibrosus,while central defects significantly altered load bearing capacity during extension.(2)Significant stress gradient concentrations were observed at the defect edges,indicating potential microinjury risk.(3)Angular endplate defects produced significant stress concentrations under dynamic loading,potentially contributing to segmental instability and accelerated degeneration.(4)These results provide a biomechanical basis for elucidating the involvement of endplate defects in intervertebral disc degeneration and facet joint injury,providing valuable guidance for early clinical identification of high-risk defect types and the development of targeted preventive strategies.

Abstract:BACKGROUND:Although cell transplantation offers a promising approach for the treatment of myocardial infarction,the low transplantation rate limits its application.Therefore,promoting the proliferation of transplanted cells and reducing apoptosis are the key issues to be solved urgently to improve the therapeutic effect. OBJECTIVE:To investigate the effects of non-coding RNA-activated by DNA damage(NORAD)on the proliferation of human induced pluripotent stem cell-derived cardiomyocytes and their apoptosis induced by oxygen-glucose deprivation/reoxygenation,as well as the effects of transplanting NORAD-overexpressing human induced pluripotent stem cell-derived cardiomyocytes(hiPSC-NORADOECMs)on cardiac function in a murine model of myocardial infarction. METHODS:The expression of NORAD in the hearts of mice at different ages(3 days old and 8 weeks old)was measured by real-time fluorescence quantitative polymerase chain reaction(RT-qPCR).A cellular model of hiPSC-NORADOECMs was established by infecting human induced pluripotent stem cells with a lentiviral vector designed to specifically upregulate NORAD,followed by directed differentiation.These cells were divided into a control group(infected with a control lentivirus)and an experimental group(infected with a NORAD-overexpressing lentivirus).The efficiency of NORAD overexpression was detected by RT-qPCR.The expression level of proliferation marker protein Ki67 was detected by cellular immunofluorescence.Intracellular reactive oxygen species levels were measured by flow cytometry after cell apoptosis was induced by oxygen-glucose deprivation/reoxygenation induction.The expression levels of Bcl-2-associated X protein(Bax),B-cell lymphoma 2(Bcl-2),and cleaved caspase-3 were analyzed by western blot assay.hiPSC-NORADOECMs were transplanted into the infarcted area of the myocardial infarction mouse model.The cardiac function was evaluated by echocardiography four weeks later. RESULTS AND CONCLUSION:(1)NORAD expression was significantly higher in the hearts of 3-day-old neonatal mice compared with 8-week-old adult mice.(2)The differentiation of human induced pluripotent stem cells into spontaneously contracting human induced pluripotent stem cell-derived cardiomyocytes was successfully achieved.(3)A stable human induced pluripotent stem cell-derived cardiomyocytes model overexpressing NORAD(hiPSC-NORADOECMs)was successfully established.(4)The expression of the proliferation marker Ki67 was significantly increased in the NORAD-overexpressing group compared with controls.(5)Compared with controls,NORAD overexpression reduced reactive oxygen species accumulation induced by oxygen-glucose deprivation/reoxygenation in human induced pluripotent stem cell-derived cardiomyocytes;Bax and cleaved caspase-3 levels were decreased,while Bcl-2 expression was upregulated.(6)Transplantation of hiPSC-NORADOECMs significantly enhanced cardiac function in a murine model of myocardial infarction.Collectively,these findings suggest that overexpression of the NORAD promotes the proliferation of human induced pluripotent stem cell-derived cardiomyocytes,reduces reactive oxygen species accumulation,and inhibits apoptosis following oxygen-glucose deprivation/reoxygenation induction,thereby enhancing the cardiac repair capacity of human induced pluripotent stem cell-derived cardiomyocytes in infarcted hearts.

Abstract:BACKGROUND:There are individual differences in the effectiveness of arthroscopic surgery in improving knee osteoarthritis,and subjective scoring scales may be biased in evaluating the clinical efficacy of arthroscopic treatment for knee osteoarthritis. OBJECTIVE:To explore the correlation between gait parameters and joint function recovery in patients with knee osteoarthritis after arthroscopic surgery. METHODS:A total of 98 patients with knee osteoarthritis admitted to Chongqing Armed Police Corps Hospital from October 2023 to October 2024 were selected as the research subjects.According to Lysholm knee function score after 6 months of follow-up,they were divided into the excellent group(n=63)and the fair group(n=35).Clinical data including gender,age,body mass index,disease duration,respiration,heart rate,Kellgren-Lawrence grade,smoking history,drinking history,hypertension history,location of onset,and postoperative complications were collected.The intraoperative and postoperative indicators,as well as the knee joint function scores and gait parameters at different times before and after surgery were compared between the two groups.Multivariate Logistic regression was used to analyze the independent influencing factors of knee joint function recovery.Stratified regression analysis was conducted to explore the impact of different clinical and pathological characteristics after treatment on gait parameters.Generalized estimating equations were used to analyze the differences in gait parameters among patients with different knee joint functions after treatment.Generalized additive models were used to analyze the impact of gait parameters after treatment on the Lysholm score.Receiver operating characteristic curves were drawn to analyze the value of gait parameters in predicting the recovery of knee joint function after treatment. RESULTS AND CONCLUSION:(1)There were statistically significant differences in age,disease duration,Kellgren-Lawrence grade,and postoperative complications between the excellent group and the fair group(P<0.05).(2)The fair group had longer operation time,more intraoperative blood loss,longer time for swelling to subside,and longer rehabilitation time than the excellent group(P<0.05).(3)The fair group had higher Western Ontario and McMaster Universities Osteoarthritis Index and Visual Analogue Scale scores,and lower Lysholm scores,step frequency,and step speed than the excellent group(P<0.05).(4)Logistic regression analysis showed that age,Kellgren-Lawrence grade,postoperative complications,and time for swelling to subside were independent risk factors for knee joint function recovery(P<0.05).(5)Stratified regression analysis showed that age,Kellgren-Lawrence grade,time for swelling to subside,and postoperative complications had negative effects on step frequency and step speed(β<0,P<0.05).(6)Generalized estimating equation analysis showed that there was a correlation between the degree of knee joint function recovery and gait characteristics(β>0,P<0.05).(7)Generalized additive model analysis showed that the impact of step frequency and step speed on the Lysholm score after treatment was linear.(8)Receiver operating characteristic curve analysis showed that the combined detection of step frequency and step speed had higher predictive efficacy(Area under the curve>0.85,P<0.05).(9)It suggests that arthroscopic surgery for knee osteoarthritis can improve knee joint function.By dynamically tracking changes in postoperative gait parameters and combining with functional scoring scales,the correlation between step frequency,step speed,and the outcome of knee joint function can be revealed,further clarifying its clinical predictive value.This provides a new quantitative tool for clinical functional assessment and enables more precise postoperative rehabilitation guidance.

Abstract:BACKGROUND:In recent years,the application of kidney organoid technology in acute kidney injury has gradually become a research hotspot.Traditional animal models have species differences from humans,and physiological and pathological processes of their kidneys cannot fully represent the human situation.Kidney organoid technology forms 3D kidney models through stem cell culture,which can simulate the complex structure and function of human kidneys.It has shown great potential in disease modeling and mechanism exploration of acute kidney injury,prediction of drug nephrotoxicity,and exploration of regeneration and repair mechanisms. OBJECTIVE:To summarize the progress in the application of organoid technology in acute kidney injury and to provide new technical approaches and research strategies for the prevention and treatment of acute kidney injury. METHODS:The relevant literature on organoids and acute kidney injury was retrieved through the China National Knowledge Infrastructure and PubMed databases,in which Chinese and English search terms mainly included"acute kidney injury,organoid,pluripotent stem cell,3D bioprinting,kidney-on-a-chip,regenerative medicine,kidney transplantation."All retrieved literature included original research articles and relevant reviews.The search period covered the establishment of each database to April 2025.A total of 99 articles were finally selected for analysis and summary. RESULTS AND CONCLUSION:(1)The cell sources reported in the current literature for inducing the formation of kidney organoids mainly include pluripotent stem cells,embryonic stem cells,and stem cells derived from urine.These kidney organoids play a significant role in in vitro drug screening,kidney development,and disease modeling.(2)3D bioprinting and chip kidney technology are emerging techniques for constructing kidney-like organs.3D bioprinting can precisely and specifically construct complex multi-cellular structures.Chip kidney technology has features such as high gas permeability,sensitivity,and low cost,which can extend the lifespan of the organoids and increase biocompatibility.It is suitable for preclinical drug development and toxicity screening.(3)The combination of gene editing technology and kidney organoid models has brought new perspectives and tools for the study of kidney diseases,drug development,and regenerative medicine.This technology can construct kidney organoids with specific reporter genes or sensitive indicators,and can also amplify and classify specific types of kidney cells in the organoids.(4)Renal organoids demonstrate unique advantages in disease simulation,drug evaluation,and exploration of regenerative treatment strategies.They can serve as in vitro models for the toxic mechanisms of drugs such as cisplatin,doxorubicin,and red yeast rice supplements that cause acute kidney injury.They can also be used to screen high-throughput drugs and therapeutic drug targets,playing a significant role in the field of regenerative medicine for kidney transplantation.

Abstract:BACKGROUND:In patients with severe medial compartment osteoarthritis of the knee combined with moderate lateral compartment osteoarthritis,it is controversial whether medial monondylar replacement alone can achieve satisfactory clinical benefit. OBJECTIVE:To compare and analyze the difference in clinical outcomes of unicompartmental knee arthroplasty and total knee arthroplasty in patients with heterogeneous degenerative changes of the knee(medial compartment Kellgren-Lawrence grade III-IV combined with lateral compartment Kellgren-Lawrence grade II). METHODS:Knee arthroplasty patients with severe medial ventricular osteoarthritis combined with mild and moderate lateral ventricular osteoarthritis shown by preoperative knee X-ray were selected and divided into unicompartmental knee arthroplasty group and total knee arthroplasty group according to different operation methods,and 50 patients were included in each group according to 1:1 pairing.Western Ontario and McMaster University Osteoarthritis Index(WOMAC),American Knee Association Score,joint amnesia score,postoperative gait parameters,and complications were collected at 3,6 months,1 and 2 years after surgery,and the relevant data were statistically analyzed to compare the differences in postoperative efficacy between the two groups. RESULTS AND CONCLUSION:(1)The American Knee Association Score and WOMAC scores of the unicompartmental knee arthroplasty group were better than those of the total knee arthroplasty group at 3,6 months and 1 year after surgery(P<0.05).Two years after surgery,American Knee Association Score and WOMAC score were not significantly different between two groups(P>0.05).(2)There was no significant difference in joint amnesia score between the two groups 3 months after operation(P>0.05).The joint amnesia score was higher in the unicompartmental knee arthroplasty group than that in the total knee arthroplasty group at 6 months,1 year and 2 years after surgery(P<0.05).(3)At 1 year after surgery,step speed and step length were better in the unicompartmental knee arthroplasty group than those in the total knee arthroplasty group(P<0.05).No statistically significant differences in step frequency were detected between the two groups(P>0.05).(4)No complications occurred in both groups within 2 years after operation.(5)Follow-up showed that unicompartmental knee arthroplasty was clinically equivalent to total knee arthroplasty in patients with severe medial compartment osteoarthritis(Kellgren-Lawrence III-IV)combined with moderate lateral compartment degeneration(Kellgren-Lawrence II)2 years after surgery.Unicompartmental knee arthroplasty had a significant biomechanical advantage within 1 year after surgery.No significant progression of lateral interventricular osteoarthritis was observed during follow-up(Kellgren-Lawrence grade increase),but further long-term observation is needed.Before making decisions,doctors should establish a multi-dimensional evaluation framework(including patient age,exercise load expectation,unicompartmental knee arthroplasty operation amount of the surgeon,etc.),and fully inform patients of the risk of lateral compartment progression,and decide whether to perform unicompartmental knee arthroplasty after comprehensive assessment.

Abstract:BACKGROUND:Periodontitis is a highly prevalent chronic inflammatory disease.Previous research has predominantly focused on specific immune cells or cytokines.Consequently,systematically elucidating its immune mechanisms and discovering novel therapeutic targets hold significant implications. OBJECTIVE:To analyze the expression profiles of periodontitis-associated immune cell subpopulations and identify key differentially expressed genes with a causal relationship to the disease,thereby exploring potential molecular mechanisms and key genes involved in periodontitis and immune cell dynamics. METHODS:Single-cell RNA sequencing data from the GEO database were used to analyze immune cell subset heterogeneity and identify differentially expressed genes.Mendelian randomization analysis was performed using expression quantitative trait loci data to infer causal relationships between immune cell gene expression and periodontitis risk.Pathway enrichment and immune infiltration analyses were performed on the identified causal genes to reveal the associations between differentially expressed genes and immune cells with the development and progression of periodontitis.CellChat trajectory analysis was used to explore intercellular communication.To validate key findings,gingival tissue samples were collected from 20 patients with periodontitis diagnosed by the Department of Stomatology at The First Affiliated Hospital of Shihezi University(periodontitis group)and 20 healthy gingival tissue samples from patients undergoing orthodontic or impacted tooth extraction(control group).RT-qPCR and immunohistochemistry were used to examine the expression of key genes. RESULTS AND CONCLUSION:Comprehensive analysis identified 23 immune cell clusters in periodontitis and three key genes(annexin A1,solute carrier family 11 member 1,and vimentin)that were significantly causally associated with periodontitis risk.Pathway enrichment analysis revealed their involvement in key immune regulatory mechanisms.Further analysis and characterization of immune subtype receptor ligands and key cell subtype trajectories revealed distinct roles for annexin A1,solute carrier family 11 member 1,and vimentin in disease progression.Annexin A1,solute carrier family 11 member 1,and vimentin mRNA expression levels were upregulated in periodontitis tissues compared with healthy controls(P<0.05).This study reveals the key role of immune cell subsets in periodontitis and validates key genes(annexin A1,solute carrier family 11 member 1,and vimentin)with a causal relationship with periodontitis.

Abstract:BACKGROUND:Stem cells show a great potential in oral tissue regeneration but face challenges such as immune rejection and tumor formation.Exosomes are nanoscale extracellular vesicles secreted by cells,reducing immunogenicity and tumor risks while maintaining stem cell functions,such as promoting angiogenesis and tissue repair. OBJECTIVE:To summarize the mechanisms and roles of exosomes in oral tissue regeneration,explore exosome engineering strategies and the challenges and future directions in the application of exosomes in oral regenerative medicine. METHODS:The relevant literature published from the WanFang and PubMed databases from their inception to 2025 was searched using Chinese search terms"stem cells,exosomes,dental pulp regeneration,periodontal regeneration"and English search terms"exosomes,stem cells,dentistry,regenerate."Finally,94 articles were included for review and analysis. RESULTS AND CONCLUSION:(1)Exosomes have lower immunogenicity and no tumorigenic risk compared with stem cells.They are more stable and easier to store and transport.Additionally,exosomes can penetrate dense tissues for targeted delivery.They can avoid the ethical and immune rejection issues faced by stem cell therapy,making them a safer and more effective treatment option.(2)Exosomes have shown significant efficacy in the regeneration of oral tissues,including dental pulp,periodontal tissue,craniofacial bone,salivary glands,nerves,and skin.They can promote tissue repair and regeneration through multiple mechanisms,demonstrating broad application prospects.(3)Engineering strategies such as pre-treatment,isolation and purification,and targeted modification can enhance the functions of exosomes,improving their therapeutic potential and clinical feasibility.However,the current technologies still have limitations.Further optimization is needed in the future to promote their widespread application.

Abstract:BACKGROUND:A combination of subjective and objective evaluation criteria is often required to more accurately and comprehensively assess knee function in patients undergoing anterior cruciate ligament reconstruction. OBJECTIVE:To review the evolving trends in effectiveness and safety evaluation criteria after anterior cruciate ligament reconstruction and analyze the dynamic shift in the use of subjective and objective assessment tools. METHODS:A systematic search of PubMed and Embase was conducted up to August 22,2023 to identify studies assessing knee function after anterior cruciate ligament reconstruction.A total of 136 eligible studies meeting the inclusion criteria were included.The frequency of each evaluation standard was extracted and analyzed over time using Origin 2025 software. RESULTS AND CONCLUSION:(1)Between 1990 and 2005,objective measures were widely applied.Since 2005,subjective scoring systems,particularly patient-reported outcome measures,have increased sharply,surpassing objective standards in frequency from 2009 onward.(2)Early use was dominated by the Lysholm scale and Tegner activity score,while the International Knee Documentation Committee-Subjective Knee Form,Knee Injury and Osteoarthritis Outcome Score,and anterior cruciate ligament-return to sport after injury gradually emerged as the main tools in later years.(3)In contrast,objective assessments such as the KT1000/2000 arthrometer,Lachman test,and hop tests remained relatively stable but showed an overall downward trend.(4)This suggests that the evaluation criteria for the effectiveness and safety of anterior cruciate ligament reconstruction have shifted from a primary focus on objective knee stability to an emphasis on patient-reported experiences.(5)This study is the first to quantitatively reveal the dynamic evolution of mainstream assessment tools.Current clinical practice highlights the integration of subjective and objective measures,and we recommend the following combination:International Knee Documentation Committee-Subjective Knee Form or Knee Injury and Osteoarthritis Outcome Score,together with anterior cruciate ligament-return to sport after injury,plus either the KT1000/2000 arthrometer or hop tests.Such a framework provides a more comprehensive reflection of both functional recovery and patient perception,offering an evidence-based foundation for the development of future integrated evaluation systems.

Abstract:BACKGROUND:Neural stem cells located in the ventricular zone and subventricular zone are crucial for cortical neurodevelopment and the treatment of neurodegenerative diseases.However,their precise regulatory mechanisms remain incompletely understood.miRNA-9 is one of the most abundantly expressed miRNAs in the vertebrate embryonic and adult brain,playing diverse roles during development.Yet,the function of miRNA-9 in neural stem cell differentiation remains unclear. OBJECTIVE:To investigate the role of miRNA-9 in regulating the differentiation of neural stem cells in the ventricular zone and subventricular zone. METHODS:Neural stem cells were isolated from the ventricular zone and subventricular zone of embryonic day 14.5 ICR mice and cultured in proliferation medium for 3-4 days to form neurospheres.The stemness of these cells was confirmed by Pax6/Nestin immunofluorescence staining.The expression profile of miRNA-9 was assessed using qRT-PCR in forebrain tissues at different developmental stages(embryonic days 12.5,14.5,16.5,18.5,postnatal days 0,and 7)as well as in in vitro cultured neural stem cells at embryonic day 14.5.Neural stem cells were transfected with either a miRNA-9 inhibitor or mimic using a transfection reagent.After 24 hours of transfection,cells were induced to differentiate for 3-4 days(for neurons)or 6-8 days(for glial cells).The differentiation ratios of neuronal and glial lineages were quantified via immunofluorescence staining for Tuj1(a neuronal marker),myelin basic protein(an oligodendrocyte marker),and glial fibrillary acidic protein(an astrocyte marker). RESULTS AND CONCLUSION:qRT-PCR results revealed that miRNA-9 was highly expressed during early embryonic stages(embryonic days 12.5-14.5),with its expression gradually decreasing as development progressed(embryonic day 16.5 to postnatal day 7).The expression level of miRNA-9 in neural stem cells at embryonic day 14.5 was approximately 90%of the expression level of the internal reference RNU6B.Functional experiments demonstrated that compared with the control group,the proportion of Tuj1-positive neurons and myelin basic protein-positive oligodendrocytes decreased in the miRNA-9 inhibition group,while the proportion of glial fibrillary acidic protein-positive astrocytes increased.Conversely,the proportion of Tuj1-positive neurons and myelin basic protein-positive oligodendrocytes increased in the miRNA-9 overexpression group,while the proportion of glial fibrillary acidic protein-positive astrocytes decreased.All differences were significant(P<0.001).Results indicate that miRNA-9 plays a bidirectional regulatory role in neural stem cell differentiation:(1)It participates in the temporal regulation of neurogenesis through a developmental-stage-specific expression pattern(high expression early,downregulation later);(2)It maintains a balance in tri-lineage differentiation by promoting neural stem cell differentiation into neurons and oligodendrocytes while inhibiting astrocyte formation.