Musculoskeletal disorders,including osteoarthritis,rheumatoid arthritis,osteoporosis,bone fracture,intervertebral disc degeneration,tendinopathy,and myopathy,are prevalent conditions that profoundly impact quality of ...Musculoskeletal disorders,including osteoarthritis,rheumatoid arthritis,osteoporosis,bone fracture,intervertebral disc degeneration,tendinopathy,and myopathy,are prevalent conditions that profoundly impact quality of life and place substantial economic burdens on healthcare systems.Traditional bulk transcriptomics,genomics,proteomics,and metabolomics have played a pivotal role in uncovering disease-associated alterations at the population level.However,these approaches are inherently limited in their ability to resolve cellular heterogeneity or to capture the spatial organization of cells within tissues,thus hindering a comprehensive understanding of the complex cellular and molecular mechanisms underlying these diseases.To address these limitations,advanced single-cell and spatial omics techniques have emerged in recent years,offering unparalleled resolution for investigating cellular diversity,tissue microenvironments,and biomolecular interactions within musculoskeletal tissues.These cutting-edge techniques enable the detailed mapping of the molecular landscapes in diseased tissues,providing transformative insights into pathophysiological processes at both the single-cell and spatial levels.This review presents a comprehensive overview of the latest omics technologies as applied to musculoskeletal research,with a particular focus on their potential to revolutionize our understanding of disease mechanisms.Additionally,we explore the power of multi-omics integration in identifying novel therapeutic targets and highlight key challenges that must be overcome to successfully translate these advancements into clinical applications.展开更多
Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders(WMSDs),with symptoms often appearing very early in one’s career[1].WMSDs are conditions affecting the muscles,bones,and nervo...Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders(WMSDs),with symptoms often appearing very early in one’s career[1].WMSDs are conditions affecting the muscles,bones,and nervous system due to occupational factors.In 2002,the International Labor Organization included musculoskeletal diseases in the International List of Occupational Diseases.China’s recently updated Classification and Catalog of Occupational Diseases has introduced two new categories of occupational illnesses,including occupational musculoskeletal disorders.WMSDs significantly impact the health and work of dentists,reducing their quality of life and causing economic losses.These disorders are multifactorial in nature,influenced by personal,psychosocial,biomechanical,and environmental factors.Dentists frequently maintain static or awkward postures during procedures,which leads to musculoskeletal strain and discomfort;additionally,long working hours contribute to psychological stress,further increasing the risk of WMSDs[2].展开更多
Background:People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehen-sive health monitoring.In the past,studies have been done on the health effects of pollutants.However,there ar...Background:People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehen-sive health monitoring.In the past,studies have been done on the health effects of pollutants.However,there are few studies on musculoskeletal disorders(MSDs),and Thailand is struggling to meet the Sustainable Development Goals.Methods:This cross-sectional study examines access to health services and factors affecting MSDs among outdoor pollution workers(OPWs).The sample group includes OPWs,including local fisherman,street vendors,public car drivers,and traffic police.We studied 50 people from each of these groups,for a total of 200 people.Data were analyzed with inferential statistics using Chi-square test,McNemar test,and Univariate logistic regression.Results:The OPWs reported experiencing significantly more total MSDs pain than they did in the past(P<0.05).Factors affecting current MSDs pain,including occupation and working days per week,were significant(P<0.05).The street vendor group and public car driver group had(odds ratio[OR]=2.253,95%confidence interval[CI]:1.101 to 5.019)and(OR=2.681,95%CI:1.191 to 6.032)times higher risks of MSDs pain,respectively.OPWs who work>5 days per week had a(OR=1.464,95%CI:1.093 to 2.704)times higher risk of MSDs pain.52.7%of OPWs with MSDs,pain(n=110)had received an annual health check-up.In the past year,50.9%had minor illnesses and 21.8%had severe illnesses.OPWs receiving free treatment and visiting health service stations for no cost comprised 77.3%and 51.8%,respectively.60.9%used their right to receive treatment with universal health insurance cards.Conclusions:The study indicates that occupational groups with MSDs pain problems should exercise this right,according to the worker protection law.Local health agencies should organize activities or create accessible media to promote preventive medicine services,as many OPWs believe that health services can only be accessed when illness occurs.展开更多
The intricate hierarchical structure of musculoskeletal tissues,including bone and interface tissues,necessitates the use of complex scaffold designs and material structures to serve as tissue-engineered substitutes.T...The intricate hierarchical structure of musculoskeletal tissues,including bone and interface tissues,necessitates the use of complex scaffold designs and material structures to serve as tissue-engineered substitutes.This has led to growing interest in the development of gradient bone scaffolds with hierarchical structures mimicking the extracellular matrix of native tissues to achieve improved therapeutic outcomes.Building on the anatomical characteristics of bone and interfacial tissues,this review provides a summary of current strategies used to design and fabricate biomimetic gradient scaffolds for repairing musculoskeletal tissues,specifically focusing on methods used to construct compositional and structural gradients within the scaffolds.The latest applications of gradient scaffolds for the regeneration of bone,osteochondral,and tendon-to-bone interfaces are presented.Furthermore,the current progress of testing gradient scaffolds in physiologically relevant animal models of skeletal repair is discussed,as well as the challenges and prospects of moving these scaffolds into clinical application for treating musculoskeletal injuries.展开更多
Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff ...Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.展开更多
Sarcopenia,a progressive and systemic skeletal muscle disorder marked by the accelerated deterioration of both muscle function and mass,is highly prevalent among the elderly population,significantly contributing to an...Sarcopenia,a progressive and systemic skeletal muscle disorder marked by the accelerated deterioration of both muscle function and mass,is highly prevalent among the elderly population,significantly contributing to an elevated risk of adverse outcomes,including falls,fractures,and muscle weakness.Clinical investigations have identified a strong correlation between sarcopenia and several prevalent degenerative skeletal muscle disorders.This correlation is attributed to imbalances in joint mechanics resulting from localized muscle atrophy and the influence of musculoskeletal secretory factors.In this review,we discuss the broader implications of sarcopenia and critically evaluate the currently established assessment methods.Furthermore,the clinical significance of prevalent musculoskeletal disorders(including osteoporosis,osteoarthritis,and spinal pathologies)in relation to sarcopenia,alongside the underlying mechanisms influencing this relationship,is summarized.Additionally,the effects of sarcopenia on the therapeutic efficacy of medications and surgical interventions for musculoskeletal conditions are reviewed.Sarcopenia is intricately linked to the onset,progression,and prognosis of musculoskeletal disorders.Future research should prioritize elucidating the potential mechanisms that connect muscle loss with skeletal muscle diseases,and investigating whether mitigating sarcopenia symptoms could decelerate the progression of these disorders,thereby paving new pathways for therapeutic interventions.展开更多
While bulk RNA sequencing and single-cell RNA sequencing have shed light on cellular heterogeneity and potential molecular mechanisms in the musculoskeletal system in both physiological and various pathological states...While bulk RNA sequencing and single-cell RNA sequencing have shed light on cellular heterogeneity and potential molecular mechanisms in the musculoskeletal system in both physiological and various pathological states,the spatial localization of cells and molecules and intercellular interactions within the tissue context require further elucidation.Spatial transcriptomics has revolutionized biological research by simultaneously capturing gene expression profiles and in situ spatial information of tissues,gradually finding applications in musculoskeletal research.This review provides a summary of recent advances in spatial transcriptomics and its application to the musculoskeletal system.The classification and characteristics of data acquisition techniques in spatial transcriptomics are briefly outlined,with an emphasis on widely-adopted representative technologies and the latest technological breakthroughs,accompanied by a concise workflow for incorporating spatial transcriptomics into musculoskeletal system research.The role of spatial transcriptomics in revealing physiological mechanisms of the musculoskeletal system,particularly during developmental processes,is thoroughly summarized.Furthermore,recent discoveries and achievements of this emerging omics tool in addressing inflammatory,traumatic,degenerative,and tumorous diseases of the musculoskeletal system are compiled.Finally,challenges and potential future directions for spatial transcriptomics,both as a field and in its applications in the musculoskeletal system,are discussed.展开更多
BACKGROUND Studies have shown that locomotive syndrome(LS)is significantly correlated with adverse outcomes,such as decreased self-care abilities,fractures,and increased mortality.Subthreshold depression(StD)is consid...BACKGROUND Studies have shown that locomotive syndrome(LS)is significantly correlated with adverse outcomes,such as decreased self-care abilities,fractures,and increased mortality.Subthreshold depression(StD)is considered an independent predictor of clinical depression,regarded as its prodromal stage,and even linked to increased mortality risk.Limited research has addressed the prevalence and relationship between LS and StD in elderly cancer patients.Understanding the prevalence of LS and StD among elderly cancer patients and elucidating their relationship will provide evidence to support the development of targeted interventions,thereby improving health outcomes in this population.AIM To investigate the relationship between musculoskeletal system function and predepressive states in elderly cancer patients.METHODS A convenience sampling method was employed to recruit 500 elderly cancer patients undergoing follow-up visits at the Department of Oncology,Affiliated Hospital of Jiangnan University,from April 2024 to December 2024.Participants completed the general information questionnaire, the 25-question Geriatric Locomotive Function Scale, and theGeriatric Depression Scale-Short Form-15. Influencing factors were analyzed, and correlation analyses wereperformed.RESULTSA total of 483 elderly cancer patients successfully completed the study. The prevalence of LS and StD amongparticipants was 56.5% and 38.7%, respectively. Logistic regression analysis identified age, tumor metastasis,exercise habits, and the presence of StD as significant risk factors for LS in elderly cancer patients. Additionally,having three or more chronic diseases and LS were significant predictors for developing StD. Spearman’s correlationanalysis revealed a significant positive correlation between LS and StD (r = 0.424, P < 0.001).CONCLUSIONElderly cancer patients exhibit a high prevalence of LS and StD, conditions which are positively correlated andmutually influential. Thus, it is critical to monitor and address pre-depressive states while evaluating and managingmotor function in this population.展开更多
Objective To determine the prevalence of lumbar spondylolysis(LS)and the proportion of spondylolytic spondylolisthesis(SS)in China,and to evaluate the musculoskeletal status of patients with LS and SS.Methods Spine Co...Objective To determine the prevalence of lumbar spondylolysis(LS)and the proportion of spondylolytic spondylolisthesis(SS)in China,and to evaluate the musculoskeletal status of patients with LS and SS.Methods Spine Computed Tomography(CT)images were collected from community populations aged 40 and above in a nationwide multi-center project.LS was diagnosed,and SS was graded by an experienced radiologist.Bone mineral density(BMD)and paraspinal muscle parameters were quantified based on CT images.Results One hundred and seventeen patients of a total of 3,317 individuals were diagnosed with LS,corresponding to a prevalence rate of 3.53%.63 of the 1,214 males(5.18%)and 54 of the 2,103 females(2.57%)were diagnosed with LS.SS occurred in 64/121 vertebrae(52.89%).BMD was not associated with LS(P=0.341).The L5 extensor paraspinal muscle density was higher in the LS group than in the non-LS group.In the LS group,patients with SS had a smaller L5 paraspinal extensor muscle cross-sectional area than those without SS(P=0.003).Conclusion The prevalence of LS in Chinese adults was 3.53%,with prevalence rates of 5.18%in males and 2.57%in females.Patients with LS have higher muscle density,whereas those with SS have smaller muscle cross-sectional areas at the L5 level.展开更多
In this editorial,we comment on the article published in a recent issue of the World Journal of Orthopedics.Although substantial literature regarding pain management of acute musculoskeletal injury has been published ...In this editorial,we comment on the article published in a recent issue of the World Journal of Orthopedics.Although substantial literature regarding pain management of acute musculoskeletal injury has been published over the last three decades,there is still a lack of evidence-based protocol for individual and population disparities.This systematic review gives us a comprehensive view of the evidence-based use of opioid vs opioid-free analgesia.Nevertheless,there is still a need for further investigation at a high level regarding this topic.展开更多
Congenital musculoskeletal and limb deformities(CMLD)seriously affect the physical and mental health of patients,and pose great challenges to healthcare systems worldwide.We explored the specific situation and changes...Congenital musculoskeletal and limb deformities(CMLD)seriously affect the physical and mental health of patients,and pose great challenges to healthcare systems worldwide.We explored the specific situation and changes of incidence,prevalence,disability-adjusted life years rates,and mortality of CMLD in under-5 children from 1990 to 2021 in different groups,including different regions,periods,genders and sociodemographic indices(SDI),through corresponding analytical models.Overall,the global disease burden of CMLD in under-5 children has decreased from 1990 to 2021.The disease burden of CMLD in under-5 children varied significantly among different regions and countries,and there was a strong correlation between the corresponding burden of disease and the level of SDI.In addition,cross-country inequality analysis showed that while absolute inequalities in the disease burden of CMLD in under-5 children have improved,relative inequalities have worsened.It is essential to reduce the global health impact of CMLD by implementing targeted interventions to improve health care in underdeveloped areas.展开更多
Background: Musculoskeletal disorders(MSDs) represent a significant global health burden. While physical activity(PA) and physical fitness are both thought to reduce MSD risk, their independent and joint associations ...Background: Musculoskeletal disorders(MSDs) represent a significant global health burden. While physical activity(PA) and physical fitness are both thought to reduce MSD risk, their independent and joint associations with MSD incidence have not been fully explored. This study investigated the independent and combined effects of PA, cardiorespiratory fitness(CRF), grip strength(GS), and GS asymmetry on MSD incidence in a large prospective cohort.Methods: We analyzed data from the UK Biobank cohort(2006-2023), including 406,080 participants aged 37-73 years(age = 55.7 ± 8.2 years,mean ± SD;53.0% female) who were free of MSD at baseline and during the first 2 years of follow-up. PA, derived from self-reported data and expressed in total metabolic equivalent hours per week(MET-h/week);CRF(watts(W)/kilogram(kg)), measured using a cycling exercise test;and GS(kg), measured by hydraulic hand dynamometer, were included as exposures. GS asymmetry was defined by the left-to-right hand strength ratio. MSD incidence was determined via hospital records. Time-to-event associations were analyzed using Cox proportional hazards regression models with restricted cubic splines to account for non-linear relationships. The analysis was conducted in April 2024.Results: Over a median follow-up of 14.7 years, a total of 73,002 incident cases of MSDs were recorded(rheumatoid arthritis: 2923;osteoarthritis:54,955;degenerative spinal diseases: 15,124). Lower self-reported PA(<4.8 MET-h/week) was associated with increased MSD risk(hazard ratio(HR) = 1.0710, 95% confidence interval(95%CI): 1.0623-1.0797). Low CRF(<1.22 W/kg;HR = 1.0941, 95%CI: 1.0596-1.1298), low GS(<27.80 kg;HR = 1.1133, 95%CI: 1.0990-1.1277), and GS asymmetry(HR = 1.1042, 95%CI: 1.0814-1.1274) were also significantly associated with increased MSD risk. Good CRF and GS, and lower GS asymmetry mitigated the higher MSD risk associated with low PA levels.Conclusion: Low levels of PA, CRF, GS, and GS asymmetry were associated with a higher risk of incident MSD. Meanwhile, improvements in CRF, GS, and GS balance could help offset the risk of MSD incidence in populations with insufficient PA.展开更多
Full waveform inversion(FWI)has showed great potential in the detection of musculoskeletal disease.However,FWI is an ill-posed inverse problem and has a high requirement on the initial model during the imaging process...Full waveform inversion(FWI)has showed great potential in the detection of musculoskeletal disease.However,FWI is an ill-posed inverse problem and has a high requirement on the initial model during the imaging process.An inaccurate initial model may lead to local minima in the inversion and unexpected imaging results caused by cycle-skipping phenomenon.Deep learning methods have been applied in musculoskeletal imaging,but need a large amount of data for training.Inspired by work related to generative adversarial networks with physical informed constrain,we proposed a method named as bone ultrasound imaging with physics informed generative adversarial network(BUIPIGAN)to achieve unsupervised multi-parameter imaging for musculoskeletal tissues,focusing on speed of sound(SOS)and density.In the in-silico experiments using a ring array transducer,conventional FWI methods and BUIPIGAN were employed for multiparameter imaging of two musculoskeletal tissue models.The results were evaluated based on visual appearance,structural similarity index measure(SSIM),signal-to-noise ratio(SNR),and relative error(RE).For SOS imaging of the tibia–fibula model,the proposed BUIPIGAN achieved accurate SOS imaging with best performance.The specific quantitative metrics for SOS imaging were SSIM 0.9573,SNR 28.70 dB,and RE 5.78%.For the multi-parameter imaging of the tibia–fibula and human forearm,the BUIPIGAN successfully reconstructed SOS and density distributions with SSIM above 94%,SNR above 21 dB,and RE below 10%.The BUIPIGAN also showed robustness across various noise levels(i.e.,30 dB,10 dB).The results demonstrated that the proposed BUIPIGAN can achieve high-accuracy SOS and density imaging,proving its potential for applications in musculoskeletal ultrasound imaging.展开更多
Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for ...Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for musculoskeletal and connective tissue disorders related to six PPI formulations—omeprazole,pantoprazole,lansoprazole,esomeprazole,rabeprazole,and dexlansoprazole—from Q12004 to Q42023 were collected from the FDA Adverse Event Reporting System(FAERS).Signal detection was performed using the Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayesian Geometric Mean(EBGM).Data processing and statistical analysis were conducted using R Studio 4.40.Results:A total of 6,635,3,853,1,792,15,731,483,and 534 adverse events were identified for the six PPIs,respectively.The four algorithms(ROR,PRR,BCPNN,and EBGM)generated 17,19,8,27,5,and 2 positive signals.Notably,signals for renal osteodystrophy and osteoporosis were more frequent,with stronger signals for lumbar flexion syndrome and renal osteodystrophy.Conclusion:Patients with chronic kidney disease,a high risk of osteoporosis and fractures,or those using statins should select PPIs with a lower risk of adverse musculoskeletal and connective tissue reactions to minimize these adverse effects and ensure standardized clinical use of PPIs.展开更多
Objective:To conduct a comprehensive bibliometric and knowledge network analysis of musculoskeletal ultrasound(MSK US)research from 2005 to 2025,with a focus on publication trends,influential authors,institutions,and ...Objective:To conduct a comprehensive bibliometric and knowledge network analysis of musculoskeletal ultrasound(MSK US)research from 2005 to 2025,with a focus on publication trends,influential authors,institutions,and thematic hotspots.Methods:Articles related to MSK US were retrieved from the Web of Science Core Collection using the search strategy TS=(“musculoskeletal ultrasound”OR“MSK ultrasound”OR“musculoskeletal ultrasonography”)AND(tendon OR ligament).Eligible studies included English-language original research and review articles published between 2005 and 2025.Bibliometric analyses were performed using VOSviewer to evaluate publication trends,co-citation networks,author collaborations,institutional and country partnerships,and keyword co-occurrence.Results:A total of 570 articles(476 original research papers and 94 reviews)were included.The annual number of publications increased exponentially,peaking in 2020.Co-citation analysis identified Wakefield(2005),Naredo,and Filippucci as foundational contributors.Author collaboration networks highlighted a strong European core centered on Italy and Spain,while institutional and country analyses revealed a“Europe–North America”dual-center pattern with growing contributions from China.Keyword co-occurrence analysis revealed three main research pillars:inflammatory arthropathies,sports-related injuries,and degenerative conditions,with emerging interest in advanced imaging techniques and artificial intelligence.Conclusion:T MSK US research has demonstrated sustained growth and diversification over the past two decades.Europe remains a traditional leader,but increasing output from North America and Asia reflects a shift toward global,multicenter collaboration.Future research should prioritize methodological standardization,integration of novel imaging technologies,and alignment with clinically meaningful outcomes to optimize diagnostic accuracy and clinical utility.展开更多
Background:Magnetic resonance imaging(MRI)is crucial in modern medical diagnostics,providing detailed insights into soft tissue structures and pathological changes.Traditional grayscale images can sometimes obscure cr...Background:Magnetic resonance imaging(MRI)is crucial in modern medical diagnostics,providing detailed insights into soft tissue structures and pathological changes.Traditional grayscale images can sometimes obscure critical details,complicating accurate interpretations.Automated color coding of the MRI signal intensities may enhance the visualization of various pa-thologies,potentially leading to improved diagnostic accuracy and image quality.This paper aims to explore the effectiveness of color-coded MR image reconstruction in enhancing both diagnostic precision and overall image quality in musculoskeletal MRI.Methods:Two fellowship-trained musculoskeletal radiologists evaluated the images reconstructed with color coding,rating their diagnostic value,image quality,and visual appeal using a five-point Likert scale.To assess interrater reliability,Cohen's Kappa statistical analysis was performed.Additionally,descriptive statistics summarizing the Likert scores for diagnostic value,image quality,and visual appeal of the reconstructed images have been described.Results:Statistical analysis of the data revealed that the diagnostic value,image value,and visual appeal of the color-coded MR images were excellent in almost two-thirds of the data set.The minimum Likert score recorded was 3,signifying a good quality rating.Conclusion:Our study shows positive results,supporting the efficiency of color-coded MR imaging in aiding the conventional gray scale MR imaging to improve its diagnostic efficiency.展开更多
BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question...BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question is“How does the use of opioid medications in pain management,compared with non-opioid medications,affect pain intensity over the short,intermediate,and long-term in adults with acute traumatic pain?”.METHODS The protocol was prospectively registered on the International Prospective Re-gister of Systematic Reviews:CRD42021279639.Medline and Google Scholar were electronically searched for controlled peer-reviewed studies published in full,with the PICO framework:P:Adult patients with traumatic injuries,I:Opioid medications,C:Non-opioid medi-cations,O:A minimum clinically important difference(MCID)in pain.RESULTS After full-text screening,we included 14 studies in the qualitative synthesis.Of these 14 studies,12 were rando-mized clinical trials(RCTs)and 2 were pseudo-RCTs with a total of 2347 patients enrolled.There was heteroge-neity in both medication utilized and outcome in these studies;only two studies were homogeneous regarding the type of study conducted,the opioid used,its comparator,and the outcome explored.The MCID was evaluated in 8 studies,while in 6 studies,any measured pain reduction was considered as an outcome.In 11 cases,the setting of care was the Emergency Department;in 2 cases,care occurred out-of-hospital;and in one case,the setting was not well-specified.The included studies were found to have a low-moderate risk of bias.CONCLUSION Non-opioids can be considered an alternative to opioids for short-term pain management of acute musculoskeletal injury.Intravenous ketamine may cause more adverse events than other routes of administration.展开更多
BACKGROUND:The widespread use of recreational drugs has raised concerns regarding their eff ects on various organ systems.The use of cannabis and opioids in chronic pain management increases their prevalence among pat...BACKGROUND:The widespread use of recreational drugs has raised concerns regarding their eff ects on various organ systems.The use of cannabis and opioids in chronic pain management increases their prevalence among patients with musculoskeletal conditions whose bone health may already be compromised.This article aims to review the pathophysiology and toxic eff ects of recreational drug use on musculoskeletal health to establish appropriate pain regimens for patients with substance use.METHODS:Medical literature published from 1970 until 2022 was identifi ed utilizing MEDLINE/PubMed and the Cochrane Library.In addition to the databases,references were obtained through the use of reference lists of published articles identifi ed by the aforementioned databases.The initial search terms included opioids,inhalants,hallucinogens,cannabis,stimulants,and bone health.There were no methodological limitations in relation to the initial acquisition and analysis of data.RESULTS:A total of 55 research articles were included in this review.Cannabis,stimulants,opioids,and inhalants impact bone maintenance,specifically osteoblast and osteoclast activity,as well as impede hormone production.These substances inhibit bone remodeling and development,manifesting as lower bone mineral density and increased fracture risk in chronic users.CONCLUSION:Although the current literature suggests a deleterious effect of recreational drugs on bone health and musculoskeletal disease,further research is warranted to evaluate the clinical effects of long-term substance use.The evaluation of such effects will aid in establishing appropriate pain regimens,as well as appropriate screening and treatment plans for recreational drug users.展开更多
Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy.Patients often suffer chronic pain and might eventually have to undergo e...Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy.Patients often suffer chronic pain and might eventually have to undergo end-stage surgery.Therefore,future treatments should focus on early detection and intervention of regional lesions.Microrobots have been gradually used in organisms due to their advantages of intelligent,precise and minimally invasive targeted delivery.Through the combination of control and imaging systems,microrobots with good biosafety can be delivered to the desired area for treatment.In the musculoskeletal system,microrobots are mainly utilized to transport stem cells/drugs or to remove hazardous substances from the body.Compared to traditional biomaterial and tissue engineering strategies,active motion improves the efficiency and penetration of local targeting of cells/drugs.This review discusses the frontier applications of microrobotic systems in different tissues of the musculoskeletal system.We summarize the challenges and barriers that hinder clinical translation by evaluating the characteristics of different microrobots and finally point out the future direction of microrobots in the musculoskeletal system.展开更多
Acupuncture is a typical example of Traditional Chinese Medicine and has been used in China for hundreds of years to treat a wide range of illnesses. However, in the clinic, issues and deficiencies were primarily seen...Acupuncture is a typical example of Traditional Chinese Medicine and has been used in China for hundreds of years to treat a wide range of illnesses. However, in the clinic, issues and deficiencies were primarily seen in four areas: loss of accuracy in the operation process;difficulty understanding the depth of acupuncture;difficulty using reinforcing and reducing techniques;and lack of a clear dynamic effect of acupuncture points following acupuncture. Musculoskeletal ultrasonography may quantitatively evaluate the acupuncture location and display the distribution of small nerves near and within the fascia of the acupuncture point in real time. The subjects were asked how they felt about receiving Qi when the needle body reached different depths and different tissues. The Qi obtained from an acupuncture point and the connective tissue of the fascia can be further understood by combining the physiological response of the acupuncture point with the anatomical structure,which offers a new method for defining the nature of the acupuncture point and standardizing the acupuncture point.展开更多
基金supported by two DoD grants(HT94252310534 to R.J.T.and HT94252310519 to C.M.K.)the following NIH/NIAMS grants:R01 grants(AR078035 and AR076900 to C.L.+10 种基金AG069401 and AG067698 to L.Q.AI186118,HD112474,and HD107034 to R.J.T.AR076325 and AR071967 to C.M.K.AR080902 and AR072999 to F.G.AR074441 and AR077678 to S.Y.T.AR082667 and AR077527 to A.E.L.AR083900,AR075860 and AR077616 to J.S.),R21 grants(AR077226 to J.S.AR083217 to A.E.L.AR081517 to S.Y.T.)a T32 grant(HD007434 to D.R.K.)P30 center grants(AR074992 and AR073752).
文摘Musculoskeletal disorders,including osteoarthritis,rheumatoid arthritis,osteoporosis,bone fracture,intervertebral disc degeneration,tendinopathy,and myopathy,are prevalent conditions that profoundly impact quality of life and place substantial economic burdens on healthcare systems.Traditional bulk transcriptomics,genomics,proteomics,and metabolomics have played a pivotal role in uncovering disease-associated alterations at the population level.However,these approaches are inherently limited in their ability to resolve cellular heterogeneity or to capture the spatial organization of cells within tissues,thus hindering a comprehensive understanding of the complex cellular and molecular mechanisms underlying these diseases.To address these limitations,advanced single-cell and spatial omics techniques have emerged in recent years,offering unparalleled resolution for investigating cellular diversity,tissue microenvironments,and biomolecular interactions within musculoskeletal tissues.These cutting-edge techniques enable the detailed mapping of the molecular landscapes in diseased tissues,providing transformative insights into pathophysiological processes at both the single-cell and spatial levels.This review presents a comprehensive overview of the latest omics technologies as applied to musculoskeletal research,with a particular focus on their potential to revolutionize our understanding of disease mechanisms.Additionally,we explore the power of multi-omics integration in identifying novel therapeutic targets and highlight key challenges that must be overcome to successfully translate these advancements into clinical applications.
基金supported by the 2021 Shandong Province Higher Education Institutions“Youth Innovation Talent Introduction and Cultivation Plan”(Public Health Safety Risk Assessment and Response Innovation Team)National Traditional Chinese Medicine Comprehensive Reform Demonstration Zone Science and Technology Co construction Project(No.GZYKJSSD-2024-106)Research Project of Shandong Educational Supervision Society(No.SDJYDDXH2023-2159).
文摘Dentistry is a profession with a high prevalence of work-related musculoskeletal disorders(WMSDs),with symptoms often appearing very early in one’s career[1].WMSDs are conditions affecting the muscles,bones,and nervous system due to occupational factors.In 2002,the International Labor Organization included musculoskeletal diseases in the International List of Occupational Diseases.China’s recently updated Classification and Catalog of Occupational Diseases has introduced two new categories of occupational illnesses,including occupational musculoskeletal disorders.WMSDs significantly impact the health and work of dentists,reducing their quality of life and causing economic losses.These disorders are multifactorial in nature,influenced by personal,psychosocial,biomechanical,and environmental factors.Dentists frequently maintain static or awkward postures during procedures,which leads to musculoskeletal strain and discomfort;additionally,long working hours contribute to psychological stress,further increasing the risk of WMSDs[2].
基金grant Fundamental Fund of National Science Research and Innovation Fund(NSRF)via Burapha University of Thailand(Grant number 52/2024).
文摘Background:People working outdoors in the Map Ta Phut pollution control area of Thailand require comprehen-sive health monitoring.In the past,studies have been done on the health effects of pollutants.However,there are few studies on musculoskeletal disorders(MSDs),and Thailand is struggling to meet the Sustainable Development Goals.Methods:This cross-sectional study examines access to health services and factors affecting MSDs among outdoor pollution workers(OPWs).The sample group includes OPWs,including local fisherman,street vendors,public car drivers,and traffic police.We studied 50 people from each of these groups,for a total of 200 people.Data were analyzed with inferential statistics using Chi-square test,McNemar test,and Univariate logistic regression.Results:The OPWs reported experiencing significantly more total MSDs pain than they did in the past(P<0.05).Factors affecting current MSDs pain,including occupation and working days per week,were significant(P<0.05).The street vendor group and public car driver group had(odds ratio[OR]=2.253,95%confidence interval[CI]:1.101 to 5.019)and(OR=2.681,95%CI:1.191 to 6.032)times higher risks of MSDs pain,respectively.OPWs who work>5 days per week had a(OR=1.464,95%CI:1.093 to 2.704)times higher risk of MSDs pain.52.7%of OPWs with MSDs,pain(n=110)had received an annual health check-up.In the past year,50.9%had minor illnesses and 21.8%had severe illnesses.OPWs receiving free treatment and visiting health service stations for no cost comprised 77.3%and 51.8%,respectively.60.9%used their right to receive treatment with universal health insurance cards.Conclusions:The study indicates that occupational groups with MSDs pain problems should exercise this right,according to the worker protection law.Local health agencies should organize activities or create accessible media to promote preventive medicine services,as many OPWs believe that health services can only be accessed when illness occurs.
基金supported by the National Natural Science Foundation of China(Grant No.52473121,52403370 and 52221006)Fundamental Research Funds for the Central Universities(buctrc202020,buctrc202312).
文摘The intricate hierarchical structure of musculoskeletal tissues,including bone and interface tissues,necessitates the use of complex scaffold designs and material structures to serve as tissue-engineered substitutes.This has led to growing interest in the development of gradient bone scaffolds with hierarchical structures mimicking the extracellular matrix of native tissues to achieve improved therapeutic outcomes.Building on the anatomical characteristics of bone and interfacial tissues,this review provides a summary of current strategies used to design and fabricate biomimetic gradient scaffolds for repairing musculoskeletal tissues,specifically focusing on methods used to construct compositional and structural gradients within the scaffolds.The latest applications of gradient scaffolds for the regeneration of bone,osteochondral,and tendon-to-bone interfaces are presented.Furthermore,the current progress of testing gradient scaffolds in physiologically relevant animal models of skeletal repair is discussed,as well as the challenges and prospects of moving these scaffolds into clinical application for treating musculoskeletal injuries.
文摘Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.
基金supported by The National Natural Science Foundation of China(82405429)The Medical and Health Science and Technology Program of Hangzhou(ZD20250272)+1 种基金Key Discipline of Traditional Chinese Medicine in Zhejiang Province(2024-XK-57)The Construction Fund of Key Medical Discipline of Hangzhou(2025HZZD16).
文摘Sarcopenia,a progressive and systemic skeletal muscle disorder marked by the accelerated deterioration of both muscle function and mass,is highly prevalent among the elderly population,significantly contributing to an elevated risk of adverse outcomes,including falls,fractures,and muscle weakness.Clinical investigations have identified a strong correlation between sarcopenia and several prevalent degenerative skeletal muscle disorders.This correlation is attributed to imbalances in joint mechanics resulting from localized muscle atrophy and the influence of musculoskeletal secretory factors.In this review,we discuss the broader implications of sarcopenia and critically evaluate the currently established assessment methods.Furthermore,the clinical significance of prevalent musculoskeletal disorders(including osteoporosis,osteoarthritis,and spinal pathologies)in relation to sarcopenia,alongside the underlying mechanisms influencing this relationship,is summarized.Additionally,the effects of sarcopenia on the therapeutic efficacy of medications and surgical interventions for musculoskeletal conditions are reviewed.Sarcopenia is intricately linked to the onset,progression,and prognosis of musculoskeletal disorders.Future research should prioritize elucidating the potential mechanisms that connect muscle loss with skeletal muscle diseases,and investigating whether mitigating sarcopenia symptoms could decelerate the progression of these disorders,thereby paving new pathways for therapeutic interventions.
基金supported by The National Natural Science Youth Foundation of China(Grant No.82102584).
文摘While bulk RNA sequencing and single-cell RNA sequencing have shed light on cellular heterogeneity and potential molecular mechanisms in the musculoskeletal system in both physiological and various pathological states,the spatial localization of cells and molecules and intercellular interactions within the tissue context require further elucidation.Spatial transcriptomics has revolutionized biological research by simultaneously capturing gene expression profiles and in situ spatial information of tissues,gradually finding applications in musculoskeletal research.This review provides a summary of recent advances in spatial transcriptomics and its application to the musculoskeletal system.The classification and characteristics of data acquisition techniques in spatial transcriptomics are briefly outlined,with an emphasis on widely-adopted representative technologies and the latest technological breakthroughs,accompanied by a concise workflow for incorporating spatial transcriptomics into musculoskeletal system research.The role of spatial transcriptomics in revealing physiological mechanisms of the musculoskeletal system,particularly during developmental processes,is thoroughly summarized.Furthermore,recent discoveries and achievements of this emerging omics tool in addressing inflammatory,traumatic,degenerative,and tumorous diseases of the musculoskeletal system are compiled.Finally,challenges and potential future directions for spatial transcriptomics,both as a field and in its applications in the musculoskeletal system,are discussed.
基金Supported by Wuxi Institute of Translational Medicine Project Program,No.LCYJ202336the Scientific and Technological Achievements Promotion Project of Wuxi Municipal Health Commission Project Program,No.T202336+1 种基金the Hospital Management Innovation Research Project of Jiangsu Hospital Association,No.JSYGY-3-2024-601Jiangsu Provincial Traditional Chinese Medicine Science and Technology Development Plan Project,No.MS2024063.
文摘BACKGROUND Studies have shown that locomotive syndrome(LS)is significantly correlated with adverse outcomes,such as decreased self-care abilities,fractures,and increased mortality.Subthreshold depression(StD)is considered an independent predictor of clinical depression,regarded as its prodromal stage,and even linked to increased mortality risk.Limited research has addressed the prevalence and relationship between LS and StD in elderly cancer patients.Understanding the prevalence of LS and StD among elderly cancer patients and elucidating their relationship will provide evidence to support the development of targeted interventions,thereby improving health outcomes in this population.AIM To investigate the relationship between musculoskeletal system function and predepressive states in elderly cancer patients.METHODS A convenience sampling method was employed to recruit 500 elderly cancer patients undergoing follow-up visits at the Department of Oncology,Affiliated Hospital of Jiangnan University,from April 2024 to December 2024.Participants completed the general information questionnaire, the 25-question Geriatric Locomotive Function Scale, and theGeriatric Depression Scale-Short Form-15. Influencing factors were analyzed, and correlation analyses wereperformed.RESULTSA total of 483 elderly cancer patients successfully completed the study. The prevalence of LS and StD amongparticipants was 56.5% and 38.7%, respectively. Logistic regression analysis identified age, tumor metastasis,exercise habits, and the presence of StD as significant risk factors for LS in elderly cancer patients. Additionally,having three or more chronic diseases and LS were significant predictors for developing StD. Spearman’s correlationanalysis revealed a significant positive correlation between LS and StD (r = 0.424, P < 0.001).CONCLUSIONElderly cancer patients exhibit a high prevalence of LS and StD, conditions which are positively correlated andmutually influential. Thus, it is critical to monitor and address pre-depressive states while evaluating and managingmotor function in this population.
基金Funding National Key R&D Program of China(2021YFC2501701,2021YFC2501703)Beijing Jishuitan Hospital Scientific Research Fund(QN202404)+1 种基金Beijing Municipal Health Commission(BJRITO-RDP-2023)Beijing Municipal Public Welfare Development and Reform Pilot Project for Medical Research Institutes(JYY2023-8).
文摘Objective To determine the prevalence of lumbar spondylolysis(LS)and the proportion of spondylolytic spondylolisthesis(SS)in China,and to evaluate the musculoskeletal status of patients with LS and SS.Methods Spine Computed Tomography(CT)images were collected from community populations aged 40 and above in a nationwide multi-center project.LS was diagnosed,and SS was graded by an experienced radiologist.Bone mineral density(BMD)and paraspinal muscle parameters were quantified based on CT images.Results One hundred and seventeen patients of a total of 3,317 individuals were diagnosed with LS,corresponding to a prevalence rate of 3.53%.63 of the 1,214 males(5.18%)and 54 of the 2,103 females(2.57%)were diagnosed with LS.SS occurred in 64/121 vertebrae(52.89%).BMD was not associated with LS(P=0.341).The L5 extensor paraspinal muscle density was higher in the LS group than in the non-LS group.In the LS group,patients with SS had a smaller L5 paraspinal extensor muscle cross-sectional area than those without SS(P=0.003).Conclusion The prevalence of LS in Chinese adults was 3.53%,with prevalence rates of 5.18%in males and 2.57%in females.Patients with LS have higher muscle density,whereas those with SS have smaller muscle cross-sectional areas at the L5 level.
基金Supported by Yuzhong District Natural Science Foundation of Chongqing,No.20240129。
文摘In this editorial,we comment on the article published in a recent issue of the World Journal of Orthopedics.Although substantial literature regarding pain management of acute musculoskeletal injury has been published over the last three decades,there is still a lack of evidence-based protocol for individual and population disparities.This systematic review gives us a comprehensive view of the evidence-based use of opioid vs opioid-free analgesia.Nevertheless,there is still a need for further investigation at a high level regarding this topic.
基金supported by the Scientific Research Projects of Colleges and Universities in Gansu Province(No.2023CYZC-03).
文摘Congenital musculoskeletal and limb deformities(CMLD)seriously affect the physical and mental health of patients,and pose great challenges to healthcare systems worldwide.We explored the specific situation and changes of incidence,prevalence,disability-adjusted life years rates,and mortality of CMLD in under-5 children from 1990 to 2021 in different groups,including different regions,periods,genders and sociodemographic indices(SDI),through corresponding analytical models.Overall,the global disease burden of CMLD in under-5 children has decreased from 1990 to 2021.The disease burden of CMLD in under-5 children varied significantly among different regions and countries,and there was a strong correlation between the corresponding burden of disease and the level of SDI.In addition,cross-country inequality analysis showed that while absolute inequalities in the disease burden of CMLD in under-5 children have improved,relative inequalities have worsened.It is essential to reduce the global health impact of CMLD by implementing targeted interventions to improve health care in underdeveloped areas.
基金supported by research grants from the National Natural Science Foundation of China(No.82001726,82301768)the National Key Research and Development programme of China(No.2024YFC3405800)+3 种基金Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(No.2019-I2M-5-066)Scientific Research Foundation provided by Pudong Hospital affiliated to Fudan University(No.YJYJRC202202)The Talents Training Program of Pudong Hospital affiliated to Fudan University(No.YQ202201)the Shanghai Municipal Science and Technology Major Project(No.2023SHZDZX02)。
文摘Background: Musculoskeletal disorders(MSDs) represent a significant global health burden. While physical activity(PA) and physical fitness are both thought to reduce MSD risk, their independent and joint associations with MSD incidence have not been fully explored. This study investigated the independent and combined effects of PA, cardiorespiratory fitness(CRF), grip strength(GS), and GS asymmetry on MSD incidence in a large prospective cohort.Methods: We analyzed data from the UK Biobank cohort(2006-2023), including 406,080 participants aged 37-73 years(age = 55.7 ± 8.2 years,mean ± SD;53.0% female) who were free of MSD at baseline and during the first 2 years of follow-up. PA, derived from self-reported data and expressed in total metabolic equivalent hours per week(MET-h/week);CRF(watts(W)/kilogram(kg)), measured using a cycling exercise test;and GS(kg), measured by hydraulic hand dynamometer, were included as exposures. GS asymmetry was defined by the left-to-right hand strength ratio. MSD incidence was determined via hospital records. Time-to-event associations were analyzed using Cox proportional hazards regression models with restricted cubic splines to account for non-linear relationships. The analysis was conducted in April 2024.Results: Over a median follow-up of 14.7 years, a total of 73,002 incident cases of MSDs were recorded(rheumatoid arthritis: 2923;osteoarthritis:54,955;degenerative spinal diseases: 15,124). Lower self-reported PA(<4.8 MET-h/week) was associated with increased MSD risk(hazard ratio(HR) = 1.0710, 95% confidence interval(95%CI): 1.0623-1.0797). Low CRF(<1.22 W/kg;HR = 1.0941, 95%CI: 1.0596-1.1298), low GS(<27.80 kg;HR = 1.1133, 95%CI: 1.0990-1.1277), and GS asymmetry(HR = 1.1042, 95%CI: 1.0814-1.1274) were also significantly associated with increased MSD risk. Good CRF and GS, and lower GS asymmetry mitigated the higher MSD risk associated with low PA levels.Conclusion: Low levels of PA, CRF, GS, and GS asymmetry were associated with a higher risk of incident MSD. Meanwhile, improvements in CRF, GS, and GS balance could help offset the risk of MSD incidence in populations with insufficient PA.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.12122403 and 12327807).
文摘Full waveform inversion(FWI)has showed great potential in the detection of musculoskeletal disease.However,FWI is an ill-posed inverse problem and has a high requirement on the initial model during the imaging process.An inaccurate initial model may lead to local minima in the inversion and unexpected imaging results caused by cycle-skipping phenomenon.Deep learning methods have been applied in musculoskeletal imaging,but need a large amount of data for training.Inspired by work related to generative adversarial networks with physical informed constrain,we proposed a method named as bone ultrasound imaging with physics informed generative adversarial network(BUIPIGAN)to achieve unsupervised multi-parameter imaging for musculoskeletal tissues,focusing on speed of sound(SOS)and density.In the in-silico experiments using a ring array transducer,conventional FWI methods and BUIPIGAN were employed for multiparameter imaging of two musculoskeletal tissue models.The results were evaluated based on visual appearance,structural similarity index measure(SSIM),signal-to-noise ratio(SNR),and relative error(RE).For SOS imaging of the tibia–fibula model,the proposed BUIPIGAN achieved accurate SOS imaging with best performance.The specific quantitative metrics for SOS imaging were SSIM 0.9573,SNR 28.70 dB,and RE 5.78%.For the multi-parameter imaging of the tibia–fibula and human forearm,the BUIPIGAN successfully reconstructed SOS and density distributions with SSIM above 94%,SNR above 21 dB,and RE below 10%.The BUIPIGAN also showed robustness across various noise levels(i.e.,30 dB,10 dB).The results demonstrated that the proposed BUIPIGAN can achieve high-accuracy SOS and density imaging,proving its potential for applications in musculoskeletal ultrasound imaging.
文摘Background:To investigate adverse event(AE)signals associated with six proton pump inhibitors(PPIs),enhance drug labeling information,and provide guidance for their safe clinical use.Methods:Adverse reaction data for musculoskeletal and connective tissue disorders related to six PPI formulations—omeprazole,pantoprazole,lansoprazole,esomeprazole,rabeprazole,and dexlansoprazole—from Q12004 to Q42023 were collected from the FDA Adverse Event Reporting System(FAERS).Signal detection was performed using the Reporting Odds Ratio(ROR),Proportional Reporting Ratio(PRR),Bayesian Confidence Propagation Neural Network(BCPNN),and Empirical Bayesian Geometric Mean(EBGM).Data processing and statistical analysis were conducted using R Studio 4.40.Results:A total of 6,635,3,853,1,792,15,731,483,and 534 adverse events were identified for the six PPIs,respectively.The four algorithms(ROR,PRR,BCPNN,and EBGM)generated 17,19,8,27,5,and 2 positive signals.Notably,signals for renal osteodystrophy and osteoporosis were more frequent,with stronger signals for lumbar flexion syndrome and renal osteodystrophy.Conclusion:Patients with chronic kidney disease,a high risk of osteoporosis and fractures,or those using statins should select PPIs with a lower risk of adverse musculoskeletal and connective tissue reactions to minimize these adverse effects and ensure standardized clinical use of PPIs.
文摘Objective:To conduct a comprehensive bibliometric and knowledge network analysis of musculoskeletal ultrasound(MSK US)research from 2005 to 2025,with a focus on publication trends,influential authors,institutions,and thematic hotspots.Methods:Articles related to MSK US were retrieved from the Web of Science Core Collection using the search strategy TS=(“musculoskeletal ultrasound”OR“MSK ultrasound”OR“musculoskeletal ultrasonography”)AND(tendon OR ligament).Eligible studies included English-language original research and review articles published between 2005 and 2025.Bibliometric analyses were performed using VOSviewer to evaluate publication trends,co-citation networks,author collaborations,institutional and country partnerships,and keyword co-occurrence.Results:A total of 570 articles(476 original research papers and 94 reviews)were included.The annual number of publications increased exponentially,peaking in 2020.Co-citation analysis identified Wakefield(2005),Naredo,and Filippucci as foundational contributors.Author collaboration networks highlighted a strong European core centered on Italy and Spain,while institutional and country analyses revealed a“Europe–North America”dual-center pattern with growing contributions from China.Keyword co-occurrence analysis revealed three main research pillars:inflammatory arthropathies,sports-related injuries,and degenerative conditions,with emerging interest in advanced imaging techniques and artificial intelligence.Conclusion:T MSK US research has demonstrated sustained growth and diversification over the past two decades.Europe remains a traditional leader,but increasing output from North America and Asia reflects a shift toward global,multicenter collaboration.Future research should prioritize methodological standardization,integration of novel imaging technologies,and alignment with clinically meaningful outcomes to optimize diagnostic accuracy and clinical utility.
文摘Background:Magnetic resonance imaging(MRI)is crucial in modern medical diagnostics,providing detailed insights into soft tissue structures and pathological changes.Traditional grayscale images can sometimes obscure critical details,complicating accurate interpretations.Automated color coding of the MRI signal intensities may enhance the visualization of various pa-thologies,potentially leading to improved diagnostic accuracy and image quality.This paper aims to explore the effectiveness of color-coded MR image reconstruction in enhancing both diagnostic precision and overall image quality in musculoskeletal MRI.Methods:Two fellowship-trained musculoskeletal radiologists evaluated the images reconstructed with color coding,rating their diagnostic value,image quality,and visual appeal using a five-point Likert scale.To assess interrater reliability,Cohen's Kappa statistical analysis was performed.Additionally,descriptive statistics summarizing the Likert scores for diagnostic value,image quality,and visual appeal of the reconstructed images have been described.Results:Statistical analysis of the data revealed that the diagnostic value,image value,and visual appeal of the color-coded MR images were excellent in almost two-thirds of the data set.The minimum Likert score recorded was 3,signifying a good quality rating.Conclusion:Our study shows positive results,supporting the efficiency of color-coded MR imaging in aiding the conventional gray scale MR imaging to improve its diagnostic efficiency.
文摘BACKGROUND The use of opioids for pain is linked to an increased risk of developing opioid use disorder,and has resulted in the emergence of the opioid crisis over the last few years.AIM The systematic review question is“How does the use of opioid medications in pain management,compared with non-opioid medications,affect pain intensity over the short,intermediate,and long-term in adults with acute traumatic pain?”.METHODS The protocol was prospectively registered on the International Prospective Re-gister of Systematic Reviews:CRD42021279639.Medline and Google Scholar were electronically searched for controlled peer-reviewed studies published in full,with the PICO framework:P:Adult patients with traumatic injuries,I:Opioid medications,C:Non-opioid medi-cations,O:A minimum clinically important difference(MCID)in pain.RESULTS After full-text screening,we included 14 studies in the qualitative synthesis.Of these 14 studies,12 were rando-mized clinical trials(RCTs)and 2 were pseudo-RCTs with a total of 2347 patients enrolled.There was heteroge-neity in both medication utilized and outcome in these studies;only two studies were homogeneous regarding the type of study conducted,the opioid used,its comparator,and the outcome explored.The MCID was evaluated in 8 studies,while in 6 studies,any measured pain reduction was considered as an outcome.In 11 cases,the setting of care was the Emergency Department;in 2 cases,care occurred out-of-hospital;and in one case,the setting was not well-specified.The included studies were found to have a low-moderate risk of bias.CONCLUSION Non-opioids can be considered an alternative to opioids for short-term pain management of acute musculoskeletal injury.Intravenous ketamine may cause more adverse events than other routes of administration.
文摘BACKGROUND:The widespread use of recreational drugs has raised concerns regarding their eff ects on various organ systems.The use of cannabis and opioids in chronic pain management increases their prevalence among patients with musculoskeletal conditions whose bone health may already be compromised.This article aims to review the pathophysiology and toxic eff ects of recreational drug use on musculoskeletal health to establish appropriate pain regimens for patients with substance use.METHODS:Medical literature published from 1970 until 2022 was identifi ed utilizing MEDLINE/PubMed and the Cochrane Library.In addition to the databases,references were obtained through the use of reference lists of published articles identifi ed by the aforementioned databases.The initial search terms included opioids,inhalants,hallucinogens,cannabis,stimulants,and bone health.There were no methodological limitations in relation to the initial acquisition and analysis of data.RESULTS:A total of 55 research articles were included in this review.Cannabis,stimulants,opioids,and inhalants impact bone maintenance,specifically osteoblast and osteoclast activity,as well as impede hormone production.These substances inhibit bone remodeling and development,manifesting as lower bone mineral density and increased fracture risk in chronic users.CONCLUSION:Although the current literature suggests a deleterious effect of recreational drugs on bone health and musculoskeletal disease,further research is warranted to evaluate the clinical effects of long-term substance use.The evaluation of such effects will aid in establishing appropriate pain regimens,as well as appropriate screening and treatment plans for recreational drug users.
基金supported by the National Natural Science Foundation of China(No.81572187,No.81871812 and No.52205590)the Natural Science Foundation of Jiangsu Province(No.BK20220834)+1 种基金project supported by Ruihua Charity Foundation(YL20220525)the Start-up Research Fund of Southeast University(No.RF1028623098).
文摘Disorders of the musculoskeletal system are the major contributors to the global burden of disease and current treatments show limited efficacy.Patients often suffer chronic pain and might eventually have to undergo end-stage surgery.Therefore,future treatments should focus on early detection and intervention of regional lesions.Microrobots have been gradually used in organisms due to their advantages of intelligent,precise and minimally invasive targeted delivery.Through the combination of control and imaging systems,microrobots with good biosafety can be delivered to the desired area for treatment.In the musculoskeletal system,microrobots are mainly utilized to transport stem cells/drugs or to remove hazardous substances from the body.Compared to traditional biomaterial and tissue engineering strategies,active motion improves the efficiency and penetration of local targeting of cells/drugs.This review discusses the frontier applications of microrobotic systems in different tissues of the musculoskeletal system.We summarize the challenges and barriers that hinder clinical translation by evaluating the characteristics of different microrobots and finally point out the future direction of microrobots in the musculoskeletal system.
文摘Acupuncture is a typical example of Traditional Chinese Medicine and has been used in China for hundreds of years to treat a wide range of illnesses. However, in the clinic, issues and deficiencies were primarily seen in four areas: loss of accuracy in the operation process;difficulty understanding the depth of acupuncture;difficulty using reinforcing and reducing techniques;and lack of a clear dynamic effect of acupuncture points following acupuncture. Musculoskeletal ultrasonography may quantitatively evaluate the acupuncture location and display the distribution of small nerves near and within the fascia of the acupuncture point in real time. The subjects were asked how they felt about receiving Qi when the needle body reached different depths and different tissues. The Qi obtained from an acupuncture point and the connective tissue of the fascia can be further understood by combining the physiological response of the acupuncture point with the anatomical structure,which offers a new method for defining the nature of the acupuncture point and standardizing the acupuncture point.
